KRISTEN MICHELLE GREEN MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125035671

License Status

EXPIRED

Business

First Name

KRISTEN

Middle

MICHELLE

Last Name

GREEN

Suffix

Business Name

KRISTEN MICHELLE GREEN MD

Original Issue Date

04/23/1997

Effective Date

04/23/1997

Expiration Date

06/30/2001

City

SPRINGFIELD

State

Zip

62794

County

SANGAMON

Specialty/Qualifier

Obstetrics & Gynecology

Ever Disciplined

LastModifiedDate

09/22/2006