MITZI M REGALA MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125058115

License Status

EXPIRED

Business

First Name

MITZI

Middle

Last Name

REGALA

Suffix

Business Name

MITZI M REGALA MD

Original Issue Date

07/01/2010

Effective Date

07/01/2010

Expiration Date

06/30/2013

City

ROCKFORD

State

Zip

61104

County

WINNEBAGO

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

10/07/2013