ELLEN THERESE HAAS MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125056269

License Status

EXPIRED

Business

Title

First Name

ELLEN

Middle

THERESE

Last Name

HAAS

Business Name

ELLEN THERESE HAAS MD

Original Issue Date

07/01/2009

Effective Date

07/01/2009

Expiration Date

06/30/2012

City

PEORIA

State

Zip

61605

County

PEORIA

Specialty/Qualifier

Obstetrics & Gynecology

Ever Disciplined

LastModifiedDate

08/29/2012