PATRICE BURCH DO - Medical Doctor License in Illinois | # 125044212

PATRICE BURCH DO

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125044212

License Status

EXPIRED

Business

N

First Name

PATRICE

Last Name

BURCH

Suffix

DO

Business Name

PATRICE BURCH DO

Original Issue Date

06/24/2002

Effective Date

06/24/2002

Expiration Date

06/23/2005

State

IL

Specialty/Qualifier

Family Medicine

Ever Disciplined

N

LastModifiedDate

09/22/2006