MARYANNE HADDAD DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125047517

License Status

EXPIRED

Business

First Name

MARYANNE

Last Name

HADDAD

Suffix

Business Name

MARYANNE HADDAD DO

Original Issue Date

06/24/2004

Effective Date

06/24/2004

Expiration Date

06/23/2007

City

SPRINGFIELD

State

Zip

62794

County

SANGAMON

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

07/03/2007