SCOTT LEWIS MIDWALL MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

VISITING PHYSICIAN PERMIT

License Number

106000463

License Status

EXPIRED

Business

Title

First Name

SCOTT

Middle

LEWIS

Last Name

MIDWALL

Business Name

SCOTT LEWIS MIDWALL MD

Original Issue Date

05/22/2012

Effective Date

05/22/2012

Expiration Date

11/21/2012

City

SPRINGFIELD

State

Zip

62769

County

SANGAMON

Ever Disciplined

LastModifiedDate

01/11/2013