MYISHA ZANINE PORTER MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125049617

License Status

EXPIRED

Business

First Name

MYISHA

Middle

ZANINE

Last Name

PORTER

Suffix

Business Name

MYISHA ZANINE PORTER MD

Original Issue Date

06/22/2005

Effective Date

06/22/2005

Expiration Date

06/21/2008

City

CHAMPAIGN

State

Zip

61822

County

CHAMPAIGN

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

06/26/2008