CHARLES HAROLD BAZUIN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036049126

License Status

NOT RENEWED

Business

First Name

CHARLES HAROLD

Last Name

BAZUIN

Suffix

Business Name

CHARLES HAROLD BAZUIN MD

Original Issue Date

05/04/1974

Effective Date

05/04/1974

Expiration Date

07/31/1987

City

ROCKFORD

State

Zip

61101

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

09/20/2006