SANDRA L ETTEMA Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036118460

License Status

ACTIVE

Business

First Name

SANDRA L

Last Name

ETTEMA

Business Name

SANDRA L ETTEMA

Original Issue Date

05/22/2007

Effective Date

05/23/2023

Expiration Date

07/31/2026

City

MATTOON

State

Zip

61938

County

COLES

Ever Disciplined

LastModifiedDate

05/23/2023