TRAVIS JAY CANOVA DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125065780

License Status

EXPIRED

Business

Title

First Name

TRAVIS

Middle

JAY

Last Name

CANOVA

Business Name

TRAVIS JAY CANOVA DO

Original Issue Date

07/01/2017

Effective Date

07/01/2017

Expiration Date

06/30/2019

City

PEORIA

State

Zip

61605

County

PEORIA

Specialty/Qualifier

Diagnostic Radiology

Ever Disciplined

LastModifiedDate

10/02/2019