JOHN EARL TILLIS MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036036764

License Status

INACTIVE

Business

First Name

JOHN EARL

Last Name

TILLIS

Suffix

Business Name

JOHN EARL TILLIS MD

Original Issue Date

09/06/1960

Effective Date

09/06/1960

Expiration Date

07/31/2002

City

ROCKFORD

State

Zip

61114

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

10/09/2006