KRISTINA RENEE ERICSSON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036127970

License Status

NOT RENEWED

Business

First Name

KRISTINA

Middle

RENEE

Last Name

ERICSSON

Suffix

Business Name

KRISTINA RENEE ERICSSON MD

Original Issue Date

05/31/2011

Effective Date

06/26/2017

Expiration Date

09/30/2020

City

SPRINGFIELD

State

Zip

62794

County

SANGAMON

Ever Disciplined

LastModifiedDate

01/14/2021