AMY J EWEN Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125040717

License Status

EXPIRED

Business

First Name

AMY

Middle

Last Name

EWEN

Business Name

AMY J EWEN

Original Issue Date

07/01/2000

Effective Date

07/01/2000

Expiration Date

06/30/2003

City

SPRINGFIELD

State

Zip

62702

County

SANGAMON

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006