COLLEEN R MARTIN Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125028005

License Status

EXPIRED

Business

First Name

COLLEEN

Middle

Last Name

MARTIN

Business Name

COLLEEN R MARTIN

Original Issue Date

05/11/1992

Effective Date

05/11/1992

Expiration Date

06/30/1995

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006