MICHAEL E CONNOLLY Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125039700

License Status

EXPIRED

Business

First Name

MICHAEL

Middle

Last Name

CONNOLLY

Business Name

MICHAEL E CONNOLLY

Original Issue Date

07/01/1999

Effective Date

07/01/1999

Expiration Date

12/28/2002

City

SPRINGFIELD

State

Zip

62794

County

SANGAMON

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006