TINA M MOLIS Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125041216

License Status

EXPIRED

Business

First Name

TINA

Middle

Last Name

MOLIS

Business Name

TINA M MOLIS

Original Issue Date

07/01/2000

Effective Date

07/01/2000

Expiration Date

06/30/2005

City

PEORIA

State

Zip

61637

County

PEORIA

Specialty/Qualifier

Diagnostic Radiology

Ever Disciplined

LastModifiedDate

09/22/2006