WADE ELIOT ANDERSON Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

LIMITED MEDICAL TEMPORARY PERMIT

License Number

130000376

License Status

EXPIRED

Business

First Name

WADE ELIOT

Last Name

ANDERSON

Business Name

WADE ELIOT ANDERSON

Original Issue Date

01/01/1997

Effective Date

01/01/1997

Expiration Date

04/02/1998

City

ROCKFORD

State

Zip

61104

County

WINNEBAGO

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/25/2006