RICHARD P PUCKETT MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036048516

License Status

NOT RENEWED

Business

First Name

RICHARD P

Last Name

PUCKETT

Suffix

Business Name

RICHARD P PUCKETT MD

Original Issue Date

12/18/1973

Effective Date

05/21/2008

Expiration Date

07/31/2011

City

BLOOMINGTON

State

Zip

61704

County

MCLEAN

Ever Disciplined

LastModifiedDate

11/14/2011