SCOTT J WEINER Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

LIMITED MEDICAL TEMPORARY PERMIT

License Number

130000223

License Status

EXPIRED

Business

First Name

SCOTT

Middle

Last Name

WEINER

Business Name

SCOTT J WEINER

Original Issue Date

08/04/1993

Effective Date

08/04/1993

Expiration Date

02/15/1996

City

EDWARDSVILLE

State

Zip

62025

County

MADISON

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

09/25/2006