PHILIP T MINER MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036069826

License Status

NOT RENEWED

Business

First Name

PHILIP T

Last Name

MINER

Suffix

Business Name

PHILIP T MINER MD

Original Issue Date

11/07/1984

Effective Date

04/24/2017

Expiration Date

09/30/2020

City

ROCKFORD

State

Zip

61103

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

01/14/2021