AMBER DALE HARTMAN DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125076229

License Status

CANCELLED

Business

Title

First Name

AMBER

Middle

DALE

Last Name

HARTMAN

Business Name

AMBER DALE HARTMAN DO

Original Issue Date

06/26/2020

Effective Date

06/26/2020

Expiration Date

06/25/2023

City

SPRINGFIELD

State

Zip

62701

County

SANGAMON

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

05/02/2020