KRISTINE MARGARET ASIS ALBA MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125060644

License Status

CANCELLED

Business

Title

First Name

KRISTINE MARGARET

Middle

ASIS

Last Name

ALBA

Business Name

KRISTINE MARGARET ASIS ALBA MD

Original Issue Date

06/30/2011

Effective Date

06/30/2011

Expiration Date

06/29/2014

City

SPRINGFIELD

State

Zip

62701

County

SANGAMON

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

07/10/2014