NORLEEN PUACHE SIMANGAN MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125060648

License Status

EXPIRED

Business

Title

First Name

NORLEEN

Middle

PUACHE

Last Name

SIMANGAN

Business Name

NORLEEN PUACHE SIMANGAN MD

Original Issue Date

07/01/2014

Effective Date

07/01/2014

Expiration Date

06/30/2015

City

PEORIA

State

Zip

61605

County

PEORIA

Specialty/Qualifier

Psychiatry

Ever Disciplined

LastModifiedDate

09/04/2015