DONNA MARIE V ECONOMOS MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125035145

License Status

EXPIRED

Business

First Name

DONNA MARIE

Middle

Last Name

ECONOMOS

Suffix

Business Name

DONNA MARIE V ECONOMOS MD

Original Issue Date

06/17/1996

Effective Date

06/17/1996

Expiration Date

06/30/1999

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006