AMY C HOLLEN MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125034551

License Status

EXPIRED

Business

First Name

AMY

Middle

Last Name

HOLLEN

Suffix

Business Name

AMY C HOLLEN MD

Original Issue Date

05/20/1996

Effective Date

05/20/1996

Expiration Date

06/30/1999

City

ROCKFORD

State

Zip

61107

County

BOONE

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006