CHRISTINA LYNN INGRAM MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****02

License Status

NOT RENEWED

Business

Title

First Name

CHRISTINA

Middle

LYNN

Last Name

INGRAM

Business Name

CHRISTINA LYNN INGRAM MD

Original Issue Date

06/01/2004

Effective Date

05/12/2011

Expiration Date

07/31/2014

City

ALTON

State

Zip

62002

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014