STEPHEN BANTA BURDON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036027403

License Status

NOT RENEWED

Business

First Name

STEPHEN BANTA

Last Name

BURDON

Suffix

Business Name

STEPHEN BANTA BURDON MD

Original Issue Date

11/29/1946

Effective Date

11/29/1946

Expiration Date

07/31/2005

City

PEORIA

State

Zip

61614

County

PEORIA

Ever Disciplined

LastModifiedDate

10/09/2006