HENRY WALTER PEMBERTON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036034673

License Status

NOT RENEWED

Business

First Name

HENRY WALTER

Last Name

PEMBERTON

Suffix

Business Name

HENRY WALTER PEMBERTON MD

Original Issue Date

08/12/1957

Effective Date

06/21/2011

Expiration Date

07/31/2014

City

ROCKFORD

State

Zip

61114

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

11/17/2014