GLEN DEAN PITTMAN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036042666

License Status

NOT RENEWED

Business

First Name

GLEN DEAN

Last Name

PITTMAN

Suffix

Business Name

GLEN DEAN PITTMAN MD

Original Issue Date

07/11/1969

Effective Date

07/12/2017

Expiration Date

09/30/2020

City

SPRINGFIELD

State

Zip

62704

County

SANGAMON

Ever Disciplined

LastModifiedDate

01/14/2021