SAM WEIR AXTELL DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036038191

License Status

NOT RENEWED

Business

First Name

SAM WEIR

Last Name

AXTELL

Suffix

Business Name

SAM WEIR AXTELL DO

Original Issue Date

11/29/1962

Effective Date

11/29/1962

City

BLOOMINGTON

State

Zip

61701

County

MCLEAN

Ever Disciplined

LastModifiedDate

09/20/2006