LUCY N WISDOM Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125041748

License Status

EXPIRED

Business

First Name

LUCY

Middle

Last Name

WISDOM

Business Name

LUCY N WISDOM

Original Issue Date

06/19/2000

Effective Date

06/19/2000

Expiration Date

06/30/2004

City

SPRINGFIELD

State

Zip

62794

County

SANGAMON

Specialty/Qualifier

Dermatology

Ever Disciplined

LastModifiedDate

09/22/2006