ALEXANDRA LEE MATHERN MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125067768

License Status

CANCELLED

Business

Title

First Name

ALEXANDRA

Middle

LEE

Last Name

MATHERN

Business Name

ALEXANDRA LEE MATHERN MD

Original Issue Date

07/01/2018

Effective Date

07/01/2018

Expiration Date

06/30/2019

City

PEORIA

State

Zip

61605

County

PEORIA

Specialty/Qualifier

Obstetrics and Gynecology

Ever Disciplined

LastModifiedDate

05/07/2018