MI RA LEE MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125059252

License Status

CANCELLED

Business

Title

First Name

MI RA

Last Name

LEE

Business Name

MI RA LEE MD

Original Issue Date

07/01/2011

Effective Date

07/01/2011

Expiration Date

06/30/2014

City

ROCKFORD

State

Zip

61104

County

WINNEBAGO

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

05/10/2011