LIDE LIU Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125046242

License Status

EXPIRED

Business

First Name

LIDE

Last Name

LIU

Business Name

LIDE LIU

Original Issue Date

06/24/2003

Effective Date

06/24/2003

Expiration Date

06/23/2006

City

SPRINGFIELD

State

Zip

62794

County

SANGAMON

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006