GEORGIE A EAPEN Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125031162

License Status

EXPIRED

Business

First Name

GEORGIE A

Last Name

EAPEN

Business Name

GEORGIE A EAPEN

Original Issue Date

05/16/1994

Effective Date

05/16/1994

Expiration Date

06/25/1997

City

SPRINGFIELD

State

Zip

62794

County

SANGAMON

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006