AMY MARIE FERGUSON MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125058761

License Status

CANCELLED

Business

Title

First Name

AMY

Middle

MARIE

Last Name

FERGUSON

Business Name

AMY MARIE FERGUSON MD

Original Issue Date

07/01/2010

Effective Date

07/01/2010

Expiration Date

06/30/2013

City

PEORIA

State

Zip

61605

County

PEORIA

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

04/20/2010