AMANDA C CROSS MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125048285

License Status

EXPIRED

Business

First Name

AMANDA

Middle

Last Name

CROSS

Suffix

Business Name

AMANDA C CROSS MD

Original Issue Date

07/01/2004

Effective Date

07/01/2004

Expiration Date

06/30/2009

City

EAST PEORIA

State

Zip

61611

County

TAZEWELL

Specialty/Qualifier

Diagnostic Radiology

Ever Disciplined

LastModifiedDate

07/15/2009