MARTINE A SCHULTHEIS MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125059864

License Status

CANCELLED

Business

Title

First Name

MARTINE

Middle

Last Name

SCHULTHEIS

Business Name

MARTINE A SCHULTHEIS MD

Original Issue Date

07/01/2014

Effective Date

07/01/2014

Expiration Date

07/31/2014

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

07/16/2014