TRACEY MICHELLE THOMPSON MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125070492

License Status

EXPIRED

Business

Title

First Name

TRACEY

Middle

MICHELLE

Last Name

THOMPSON

Business Name

TRACEY MICHELLE THOMPSON MD

Original Issue Date

07/01/2020

Effective Date

07/01/2020

Expiration Date

06/30/2021

City

PEORIA

State

Zip

61637

County

PEORIA

Specialty/Qualifier

Internal Medicine/Pediatrics

Ever Disciplined

LastModifiedDate

10/11/2022