NIROGH GLEN VALENTINE MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125058938

License Status

CANCELLED

Business

First Name

NIROGH

Middle

GLEN

Last Name

VALENTINE

Suffix

Business Name

NIROGH GLEN VALENTINE MD

Original Issue Date

07/02/2010

Effective Date

07/02/2010

Expiration Date

07/01/2013

City

ROCKFORD

State

Zip

61104

County

WINNEBAGO

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

07/02/2010