ALEXANDER V POTERMIN MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125038803

License Status

EXPIRED

Business

First Name

ALEXANDER

Middle

Last Name

POTERMIN

Suffix

Business Name

ALEXANDER V POTERMIN MD

Original Issue Date

08/07/1998

Effective Date

08/07/1998

Expiration Date

08/06/2001

City

ROCKFORD

State

Zip

61104

County

WINNEBAGO

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006