LEO RICHARD GREEN MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036034568

License Status

INACTIVE

Business

First Name

LEO RICHARD

Last Name

GREEN

Suffix

Business Name

LEO RICHARD GREEN MD

Original Issue Date

07/11/1957

Effective Date

07/11/1957

Expiration Date

07/31/2005

City

GODFREY

State

Zip

62035

County

MADISON

Ever Disciplined

LastModifiedDate

10/09/2006