LAURA ELIZABETH HOLZUM MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125060048

License Status

CANCELLED

Business

Title

First Name

LAURA

Middle

ELIZABETH

Last Name

HOLZUM

Business Name

LAURA ELIZABETH HOLZUM MD

Original Issue Date

06/26/2011

Effective Date

06/26/2011

Expiration Date

06/25/2014

City

SPRINGFIELD

State

Zip

62701

County

SANGAMON

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

05/16/2011