KATHERINE ELLEN JUSTICE DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125075048

License Status

CANCELLED

Business

Title

First Name

KATHERINE

Middle

ELLEN

Last Name

JUSTICE

Business Name

KATHERINE ELLEN JUSTICE DO

Original Issue Date

07/01/2019

Effective Date

07/01/2019

Expiration Date

06/30/2022

City

PEORIA

State

Zip

61605

County

PEORIA

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

05/13/2019