PHILIP B JOHNSON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036044383

License Status

NOT RENEWED

Business

First Name

PHILIP B

Last Name

JOHNSON

Suffix

Business Name

PHILIP B JOHNSON MD

Original Issue Date

07/07/1971

Effective Date

08/25/2020

Expiration Date

07/31/2023

City

MAHOMET

State

Zip

61853

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

11/30/2023