VLADISLAV ISAAK GORENGAUT MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125039093

License Status

EXPIRED

Business

First Name

VLADISLAV

Middle

ISAAK

Last Name

GORENGAUT

Suffix

Business Name

VLADISLAV ISAAK GORENGAUT MD

Original Issue Date

06/26/1999

Effective Date

06/26/1999

Expiration Date

06/25/2002

City

SPRINGFIELD

State

Zip

62794

County

SANGAMON

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006