MICHAEL L GREEN MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125036767

License Status

EXPIRED

Business

First Name

MICHAEL

Middle

Last Name

GREEN

Suffix

Business Name

MICHAEL L GREEN MD

Original Issue Date

06/16/1997

Effective Date

06/16/1997

Expiration Date

06/30/2002

City

PEORIA

State

Zip

61637

County

PEORIA

Specialty/Qualifier

General Surgery

Ever Disciplined

LastModifiedDate

09/22/2006