SUSAN A BARDWELL Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036095500

License Status

NOT RENEWED

Business

First Name

SUSAN A

Last Name

BARDWELL

Business Name

SUSAN A BARDWELL

Original Issue Date

05/23/1997

Effective Date

05/23/1997

Expiration Date

07/31/2005

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

10/09/2006