JONGJIN ANNE MARTIN MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125061656

License Status

CANCELLED

Business

First Name

JONGJIN

Middle

ANNE

Last Name

MARTIN

Suffix

Business Name

JONGJIN ANNE MARTIN MD

Original Issue Date

06/25/2015

Effective Date

06/25/2015

Expiration Date

06/24/2016

City

SPRINGFIELD

State

Zip

62702

Specialty/Qualifier

Obstetrics and Gynecology

Ever Disciplined

LastModifiedDate

03/06/2015