DIANA LILY MITCHELL MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125048132

License Status

CANCELLED

Business

First Name

DIANA

Middle

LILY

Last Name

MITCHELL

Suffix

Business Name

DIANA LILY MITCHELL MD

Original Issue Date

06/24/2004

Effective Date

06/24/2004

Expiration Date

06/23/2007

City

LA GRANGE HIGHLANDS

State

Zip

60525

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

09/22/2006