EDITH M CULLEN MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125048275

License Status

EXPIRED

Business

First Name

EDITH

Middle

Last Name

CULLEN

Suffix

Business Name

EDITH M CULLEN MD

Original Issue Date

07/01/2004

Effective Date

07/01/2004

Expiration Date

06/30/2005

City

PEORIA

State

Zip

61637

County

PEORIA

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006