ALLISON GINA FAHY MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125057267

License Status

CANCELLED

Business

Title

First Name

ALLISON

Middle

GINA

Last Name

FAHY

Business Name

ALLISON GINA FAHY MD

Original Issue Date

09/03/2009

Effective Date

09/03/2009

Expiration Date

09/02/2012

City

PEORIA

State

Zip

61605

County

PEORIA

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

09/03/2009