AMANDA L PEREZ MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125071542

License Status

CANCELLED

Business

First Name

AMANDA

Middle

Last Name

PEREZ

Suffix

Business Name

AMANDA L PEREZ MD

Original Issue Date

07/06/2017

Effective Date

07/06/2017

Expiration Date

07/05/2020

City

ROCKFORD

State

Zip

61104

County

WINNEBAGO

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

07/06/2017