EDISSON XAVIER VEGA CORDOVA MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125053608

License Status

EXPIRED

Business

First Name

EDISSON

Middle

XAVIER

Last Name

VEGA CORDOVA

Suffix

Business Name

EDISSON XAVIER VEGA CORDOVA MD

Original Issue Date

06/26/2010

Effective Date

06/26/2010

Expiration Date

06/25/2012

City

SPRINGFIELD

State

Zip

62701

County

SANGAMON

Specialty/Qualifier

Otolaryngology

Ever Disciplined

LastModifiedDate

08/29/2012