CAROL E CHAMBERLAIN Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

LIMITED MEDICAL TEMPORARY PERMIT

License Number

130000320

License Status

EXPIRED

Business

First Name

CAROL

Middle

Last Name

CHAMBERLAIN

Business Name

CAROL E CHAMBERLAIN

Original Issue Date

03/19/1996

Effective Date

03/19/1996

Expiration Date

08/31/1997

City

ROCKFORD

State

Zip

61103

County

WINNEBAGO

Specialty/Qualifier

Obstetrics & Gynecology

Ever Disciplined

LastModifiedDate

09/25/2006