WENDY L VAN ITTERSUM Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125045895

License Status

EXPIRED

Business

First Name

WENDY

Middle

Last Name

VAN ITTERSUM

Business Name

WENDY L VAN ITTERSUM

Original Issue Date

07/01/2003

Effective Date

07/01/2003

Expiration Date

06/30/2006

City

PEORIA

State

Zip

61637

County

PEORIA

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

09/22/2006