ERIC D BULLOCK - Medical Doctor License in Illinois | # 125038602

ERIC D BULLOCK

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125038602

License Status

EXPIRED

Business

N

First Name

ERIC

Middle

D

Last Name

BULLOCK

Business Name

ERIC D BULLOCK

Original Issue Date

06/23/1998

Effective Date

06/23/1998

Expiration Date

06/22/2001

State

IL

Specialty/Qualifier

Internal Medicine

Ever Disciplined

N

LastModifiedDate

09/22/2006