AMY KATHLEEN MACDOUGALL MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125053644

License Status

EXPIRED

Business

First Name

AMY

Middle

KATHLEEN

Last Name

MACDOUGALL

Suffix

Business Name

AMY KATHLEEN MACDOUGALL MD

Original Issue Date

06/25/2007

Effective Date

06/25/2007

Expiration Date

06/24/2010

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

06/24/2010