MATTHEW R THOMAS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125062495

License Status

NOT RENEWED

Business

First Name

MATTHEW

Middle

Last Name

THOMAS

Suffix

Business Name

MATTHEW R THOMAS MD

Original Issue Date

09/17/2012

Effective Date

09/17/2012

Expiration Date

09/16/2015

City

ROCKFORD

State

Zip

61104

County

WINNEBAGO

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

01/07/2016