LEROY PHILLIP BACH MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036040550

License Status

NOT RENEWED

Business

First Name

LEROY PHILLIP

Last Name

BACH

Suffix

Business Name

LEROY PHILLIP BACH MD

Original Issue Date

08/18/1966

Effective Date

07/14/2011

Expiration Date

07/31/2014

City

ROCKFORD

State

Zip

61108

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

11/17/2014