PAUL ALLEN WHITE MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125044906

License Status

CANCELLED

Business

First Name

PAUL

Middle

ALLEN

Last Name

WHITE

Suffix

Business Name

PAUL ALLEN WHITE MD

Original Issue Date

07/01/2002

Effective Date

07/01/2002

Expiration Date

06/30/2005

City

SPRINGFIELD

State

Zip

62794

County

SANGAMON

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006