CAROLINE MODUPE AMAO MD - Medical Doctor License in Illinois | # 125042022

CAROLINE MODUPE AMAO MD

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125042022

License Status

EXPIRED

Business

N

First Name

CAROLINE

Middle

MODUPE

Last Name

AMAO

Suffix

MD

Business Name

CAROLINE MODUPE AMAO MD

Original Issue Date

07/01/2000

Effective Date

07/01/2000

Expiration Date

09/21/2003

State

IL

Specialty/Qualifier

Family Medicine

Ever Disciplined

N

LastModifiedDate

09/22/2006