RALPH WILLIAM THEOBALD MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036033456

License Status

INACTIVE

Business

First Name

RALPH WILLIAM

Last Name

THEOBALD

Suffix

Business Name

RALPH WILLIAM THEOBALD MD

Original Issue Date

05/24/1955

Effective Date

05/24/1955

Expiration Date

07/31/1990

City

QUINCY

State

Zip

62301

County

ADAMS

Ever Disciplined

LastModifiedDate

09/20/2006