ANDREA M HUMPHREY MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125038045

License Status

EXPIRED

Business

First Name

ANDREA

Middle

Last Name

HUMPHREY

Suffix

Business Name

ANDREA M HUMPHREY MD

Original Issue Date

07/01/1998

Effective Date

07/01/1998

Expiration Date

06/30/2000

City

SPRINGFIELD

State

Zip

62702

County

SANGAMON

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006