CHENELLE MAHALIA CHRYSTAL JOSEPH MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125062271

License Status

CANCELLED

Business

First Name

CHENELLE MAHALIA

Middle

CHRYSTAL

Last Name

JOSEPH

Suffix

Business Name

CHENELLE MAHALIA CHRYSTAL JOSEPH MD

Original Issue Date

06/28/2015

Effective Date

06/28/2015

Expiration Date

06/27/2017

City

SPRINGFIELD

State

Zip

62701

County

SANGAMON

Specialty/Qualifier

Internal Medicine/Psychiatry

Ever Disciplined

LastModifiedDate

01/27/2015