TISHA L SPENCE MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

LIMITED MEDICAL TEMPORARY PERMIT

License Number

130000932

License Status

EXPIRED

Business

Title

First Name

TISHA

Middle

Last Name

SPENCE

Business Name

TISHA L SPENCE MD

Original Issue Date

10/22/2012

Effective Date

10/22/2012

Expiration Date

04/21/2013

City

SPRINGFIELD

State

Zip

62794

County

SANGAMON

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

05/15/2013