TERRY ARTHUR TRAVIS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036046727

License Status

NOT RENEWED

Business

First Name

TERRY ARTHUR

Last Name

TRAVIS

Suffix

Business Name

TERRY ARTHUR TRAVIS MD

Original Issue Date

12/13/1972

Effective Date

07/11/2017

Expiration Date

09/30/2020

City

SPRINGFIELD

State

Zip

62711

County

SANGAMON

Ever Disciplined

LastModifiedDate

01/14/2021