DAVID MEDINA MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125082387

License Status

ACTIVE

Business

Title

First Name

DAVID

Last Name

MEDINA

Business Name

DAVID MEDINA MD

Original Issue Date

06/26/2023

Effective Date

06/26/2023

Expiration Date

06/25/2026

City

SPRINGFIELD

State

Zip

62794

County

SANGAMON

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

05/02/2023