AMEHA AMENE HAGOS MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125051290

License Status

CANCELLED

Business

First Name

AMEHA

Middle

AMENE

Last Name

HAGOS

Suffix

Business Name

AMEHA AMENE HAGOS MD

Original Issue Date

07/01/2006

Effective Date

07/01/2006

Expiration Date

06/30/2009

City

GRANITE CITY

State

Zip

62040

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006