JAMIE N WALLMAN MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125044483

License Status

CANCELLED

Business

Title

First Name

JAMIE

Middle

Last Name

WALLMAN

Business Name

JAMIE N WALLMAN MD

Original Issue Date

08/03/2018

Effective Date

08/03/2018

Expiration Date

08/02/2021

City

SPRINGFIELD

State

Zip

62701

County

SANGAMON

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

08/03/2018

Case Number

2006001449

Action

Revocation

Discipline Start Date

06/06/2008

Discipline End Date

08/02/2018

Discipline Reason

Diversion of controlled substances and physical impairment.