MEREDITH ANN MAIN MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125070752

License Status

CANCELLED

Business

Title

First Name

MEREDITH

Middle

ANN

Last Name

MAIN

Business Name

MEREDITH ANN MAIN MD

Original Issue Date

06/24/2017

Effective Date

06/24/2017

Expiration Date

06/23/2020

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

05/01/2017