REGINA MOORE POWERS MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125035051

License Status

CANCELLED

Business

First Name

REGINA

Middle

MOORE

Last Name

POWERS

Suffix

Business Name

REGINA MOORE POWERS MD

Original Issue Date

06/13/1996

Effective Date

06/13/1996

Expiration Date

06/30/1999

City

PEORIA

State

Zip

61603

County

PEORIA

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006