REBECCA PAULA GREEN Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036127136

License Status

NOT RENEWED

Business

First Name

REBECCA

Middle

PAULA

Last Name

GREEN

Business Name

REBECCA PAULA GREEN

Original Issue Date

01/25/2011

Effective Date

06/09/2017

Expiration Date

09/30/2020

City

SPRINGFIELD

State

Zip

62702

County

SANGAMON

Ever Disciplined

LastModifiedDate

01/14/2021