CAROLINE MODUPE AMAO MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125042022

License Status

EXPIRED

Business

First Name

CAROLINE

Middle

MODUPE

Last Name

AMAO

Suffix

Business Name

CAROLINE MODUPE AMAO MD

Original Issue Date

07/01/2000

Effective Date

07/01/2000

Expiration Date

09/21/2003

City

BELLEVILLE

State

Zip

62220

County

SAINT CLAIR

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006