TABATHA SELINA WELLS MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125055798

License Status

CANCELLED

Business

Title

First Name

TABATHA

Middle

SELINA

Last Name

WELLS

Business Name

TABATHA SELINA WELLS MD

Original Issue Date

06/26/2009

Effective Date

06/26/2009

Expiration Date

06/25/2012

City

CHATHAM

State

Zip

62629

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

04/30/2009