MARY J GORMAN MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125017095

License Status

EXPIRED

Business

First Name

MARY

Middle

Last Name

GORMAN

Suffix

Business Name

MARY J GORMAN MD

Original Issue Date

06/22/1984

Effective Date

06/22/1984

Expiration Date

06/26/1986

City

SPRINGFIELD

State

Zip

62708

County

SANGAMON

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006