REBECCA E ORTIZ-MELVIN DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125049138

License Status

CANCELLED

Business

First Name

REBECCA

Middle

Last Name

ORTIZ-MELVIN

Suffix

Business Name

REBECCA E ORTIZ-MELVIN DO

Original Issue Date

07/01/2005

Effective Date

07/01/2005

Expiration Date

06/30/2008

City

PEORIA

State

Zip

61637

County

PEORIA

Ever Disciplined

LastModifiedDate

09/22/2006