ELLAINE AGRAVIADOR ALCARAZ MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125051875

License Status

EXPIRED

Business

First Name

ELLAINE

Middle

AGRAVIADOR

Last Name

ALCARAZ

Suffix

Business Name

ELLAINE AGRAVIADOR ALCARAZ MD

Original Issue Date

07/01/2006

Effective Date

07/01/2006

Expiration Date

06/30/2009

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

07/15/2009