RICHARD COPELAND BERTIE III MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036053390

License Status

NOT RENEWED

Business

First Name

RICHARD COPELAND

Last Name

BERTIE III

Suffix

Business Name

RICHARD COPELAND BERTIE III MD

Original Issue Date

08/25/1976

Effective Date

08/25/1976

City

SPRINGFIELD

State

Zip

62703

County

SANGAMON

Ever Disciplined

LastModifiedDate

09/20/2006