MICHAEL J MARTIN MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125044511

License Status

EXPIRED

Business

Title

First Name

MICHAEL

Middle

Last Name

MARTIN

Business Name

MICHAEL J MARTIN MD

Original Issue Date

06/26/2002

Effective Date

06/26/2002

Expiration Date

06/25/2005

City

SPRINGFIELD

State

Zip

62794

County

SANGAMON

Ever Disciplined

LastModifiedDate

09/22/2006