SUSAN MARY TUCKER MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036088398

License Status

NOT RENEWED

Business

First Name

SUSAN MARY

Last Name

TUCKER

Suffix

Business Name

SUSAN MARY TUCKER MD

Original Issue Date

05/09/1994

Effective Date

05/09/1994

Expiration Date

07/31/1999

City

SPRINGFIELD

State

Zip

62701

County

SANGAMON

Ever Disciplined

LastModifiedDate

09/20/2006