ELZABETH SUSAN FERIK Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

LIMITED MEDICAL TEMPORARY PERMIT

License Number

130000616

License Status

EXPIRED

Business

First Name

ELZABETH

Middle

SUSAN

Last Name

FERIK

Business Name

ELZABETH SUSAN FERIK

Original Issue Date

06/11/2004

Effective Date

06/11/2004

Expiration Date

12/10/2004

City

ROCKFORD

State

Zip

61103

County

WINNEBAGO

Specialty/Qualifier

Maternal-Fetal Medicine

Ever Disciplined

LastModifiedDate

09/25/2006