LAURA M PITTMAN Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036113747

License Status

NOT RENEWED

Business

First Name

LAURA

Middle

Last Name

PITTMAN

Business Name

LAURA M PITTMAN

Original Issue Date

05/20/2005

Effective Date

06/30/2008

Expiration Date

07/31/2011

City

ROCKFORD

State

Zip

61103

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

11/14/2011