MATTHEW J LICKERMAN - Medical Doctor License in Illinois | # 125040887

MATTHEW J LICKERMAN

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125040887

License Status

EXPIRED

Business

N

First Name

MATTHEW

Middle

J

Last Name

LICKERMAN

Business Name

MATTHEW J LICKERMAN

Original Issue Date

06/21/2000

Effective Date

06/21/2000

Expiration Date

06/20/2003

State

IL

Specialty/Qualifier

Emergency Medicine

Ever Disciplined

N

LastModifiedDate

09/22/2006