AMANDA HOPE CHAMPLAIN MD - Medical Doctor License in Illinois | # 125066256

AMANDA HOPE CHAMPLAIN MD

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125066256

License Status

EXPIRED

Business

N

Title

MD

First Name

AMANDA

Middle

HOPE

Last Name

CHAMPLAIN

Business Name

AMANDA HOPE CHAMPLAIN MD

Original Issue Date

07/01/2015

Effective Date

07/01/2015

Expiration Date

06/30/2018

State

IL

Specialty/Qualifier

Dermatology

Ever Disciplined

N

LastModifiedDate

10/25/2018