SARA KNEEDLER MODERT Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125022701

License Status

EXPIRED

Business

First Name

SARA

Last Name

KNEEDLER MODERT

Business Name

SARA KNEEDLER MODERT

Original Issue Date

06/07/1988

Effective Date

06/07/1988

Expiration Date

07/01/1991

City

PEORIA

State

Zip

61603

County

PEORIA

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006