LISA RENEE WATERMAN DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

LIMITED MEDICAL TEMPORARY PERMIT

License Number

130000406

License Status

EXPIRED

Business

First Name

LISA

Middle

RENEE

Last Name

WATERMAN

Suffix

Business Name

LISA RENEE WATERMAN DO

Original Issue Date

05/20/1998

Effective Date

05/20/1998

Expiration Date

06/30/1998

City

ROCKFORD

State

Zip

61103

County

WINNEBAGO

Specialty/Qualifier

Obstetrics & Gynecology

Ever Disciplined

LastModifiedDate

09/25/2006