MARTHA S BURK MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036107213

License Status

NOT RENEWED

Business

First Name

MARTHA

Middle

Last Name

BURK

Suffix

Business Name

MARTHA S BURK MD

Original Issue Date

06/13/2002

Effective Date

12/19/2008

Expiration Date

07/31/2011

City

EDWARDSVILLE

State

Zip

62025

County

MADISON

Ever Disciplined

LastModifiedDate

11/14/2011