MARK R PHILLIPS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036067854

License Status

NOT RENEWED

Business

First Name

MARK R

Last Name

PHILLIPS

Suffix

Business Name

MARK R PHILLIPS MD

Original Issue Date

10/26/1983

Effective Date

07/15/2020

Expiration Date

07/31/2023

City

PEORIA

State

Zip

61614

County

PEORIA

Ever Disciplined

LastModifiedDate

11/30/2023