ERICA LANE CONRAD MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125059644

License Status

EXPIRED

Business

Title

First Name

ERICA

Middle

LANE

Last Name

CONRAD

Business Name

ERICA LANE CONRAD MD

Original Issue Date

07/01/2011

Effective Date

07/01/2011

Expiration Date

06/30/2014

City

BELLEVILLE

State

Zip

62220

County

SAINT CLAIR

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

03/13/2015