JERRY L AXTELL MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036087931

License Status

NOT RENEWED

Business

First Name

JERRY L

Last Name

AXTELL

Suffix

Business Name

JERRY L AXTELL MD

Original Issue Date

01/14/1994

Effective Date

01/14/1994

Expiration Date

07/31/1996

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

09/20/2006