AMY MARIE FERGUSON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036131948

License Status

NOT RENEWED

Business

Title

First Name

AMY

Middle

MARIE

Last Name

FERGUSON

Business Name

AMY MARIE FERGUSON MD

Original Issue Date

01/16/2013

Effective Date

01/16/2013

Expiration Date

07/31/2014

City

PEORIA

State

Zip

61615

County

PEORIA

Ever Disciplined

LastModifiedDate

11/17/2014