TRACY A MIZEUR Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125043983

License Status

EXPIRED

Business

First Name

TRACY

Middle

Last Name

MIZEUR

Business Name

TRACY A MIZEUR

Original Issue Date

04/22/2002

Effective Date

04/22/2002

Expiration Date

06/30/2005

City

SPRINGFIELD

State

Zip

62794

County

SANGAMON

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006