SAMANTHA ASHLEY WARD DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125077766

License Status

CANCELLED

Business

Title

First Name

SAMANTHA

Middle

ASHLEY

Last Name

WARD

Business Name

SAMANTHA ASHLEY WARD DO

Original Issue Date

07/01/2021

Effective Date

07/01/2021

Expiration Date

06/30/2024

City

PEORIA

State

Zip

61605

County

PEORIA

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

04/20/2021