YURI FEDOROVICH MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125073533

License Status

CANCELLED

Business

Title

First Name

YURI

Last Name

FEDOROVICH

Business Name

YURI FEDOROVICH MD

Original Issue Date

06/26/2019

Effective Date

06/26/2019

Expiration Date

06/25/2022

City

SPRINGFIELD

State

Zip

62701

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

04/15/2019