ANNA ILLNER MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036112421

License Status

NOT RENEWED

Business

First Name

ANNA

Last Name

ILLNER

Suffix

Business Name

ANNA ILLNER MD

Original Issue Date

09/23/2004

Effective Date

09/23/2004

Expiration Date

07/31/2005

City

INDIANAPOLIS

State

Zip

46202

County

INDIANA

Ever Disciplined

LastModifiedDate

10/09/2006