PAUL D REVIS MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036067857

License Status

ACTIVE

Business

First Name

PAUL D

Last Name

REVIS

Suffix

Business Name

PAUL D REVIS MD

Original Issue Date

10/26/1983

Effective Date

06/22/2023

Expiration Date

07/31/2026

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

06/22/2023