LISA NOELLE RUCKMAN MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125058510

License Status

CANCELLED

Business

Title

First Name

LISA

Middle

NOELLE

Last Name

RUCKMAN

Business Name

LISA NOELLE RUCKMAN MD

Original Issue Date

10/20/2011

Effective Date

10/20/2011

Expiration Date

06/30/2013

City

PEORIA

State

Zip

61605

County

PEORIA

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

10/20/2011