MARY GRACE PEREZ HIPOLITO MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125047585

License Status

EXPIRED

Business

First Name

MARY GRACE

Middle

PEREZ

Last Name

HIPOLITO

Suffix

Business Name

MARY GRACE PEREZ HIPOLITO MD

Original Issue Date

07/01/2004

Effective Date

07/01/2004

Expiration Date

06/30/2007

City

ROCKFORD

State

Zip

61104

County

WINNEBAGO

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

07/03/2007