EDITHA DONICIA JOHNSON DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125067829

License Status

EXPIRED

Business

Title

First Name

EDITHA

Middle

DONICIA

Last Name

JOHNSON

Business Name

EDITHA DONICIA JOHNSON DO

Original Issue Date

07/01/2018

Effective Date

07/01/2018

Expiration Date

06/30/2019

City

PEORIA

State

Zip

60605

County

COOK

Specialty/Qualifier

Neurology

Ever Disciplined

LastModifiedDate

10/02/2019