MARIE NGOM MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125043844

License Status

EXPIRED

Business

Title

First Name

MARIE

Last Name

NGOM

Business Name

MARIE NGOM MD

Original Issue Date

02/25/2002

Effective Date

02/25/2002

Expiration Date

06/30/2005

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006