AMY MARIE FERGUSON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****64

License Status

NOT RENEWED

Business

Title

First Name

AMY

Middle

MARIE

Last Name

FERGUSON

Business Name

AMY MARIE FERGUSON MD

Original Issue Date

04/10/2013

Effective Date

04/10/2013

Expiration Date

07/31/2014

City

PEORIA

State

Zip

61615

County

PEORIA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014