AMY LYNN DOHERTY Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125062322

License Status

CANCELLED

Business

First Name

AMY

Middle

LYNN

Last Name

DOHERTY

Business Name

AMY LYNN DOHERTY

Original Issue Date

07/01/2012

Effective Date

07/01/2012

Expiration Date

06/30/2015

City

NORMAL

State

Zip

61761

County

MCLEAN

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

03/24/2014