AMY LYNN INGRAM Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125057082

License Status

EXPIRED

Business

First Name

AMY

Middle

LYNN

Last Name

INGRAM

Business Name

AMY LYNN INGRAM

Original Issue Date

06/26/2012

Effective Date

06/26/2012

Expiration Date

06/25/2014

City

SPRINGFIELD

State

Zip

62701

County

SANGAMON

Specialty/Qualifier

Otolaryngology

Ever Disciplined

LastModifiedDate

03/13/2015