CRISTY A ELVING-DIAL MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125040113

License Status

EXPIRED

Business

First Name

CRISTY

Middle

Last Name

ELVING-DIAL

Suffix

Business Name

CRISTY A ELVING-DIAL MD

Original Issue Date

07/01/1999

Effective Date

07/01/1999

Expiration Date

06/30/2002

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006