WONIL TAE MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125050729

License Status

CANCELLED

Business

Title

First Name

WONIL

Last Name

TAE

Business Name

WONIL TAE MD

Original Issue Date

06/24/2006

Effective Date

06/24/2006

Expiration Date

06/23/2009

City

ALTON

State

Zip

62002

County

MADISON

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006