TRAVIS L BULLOCK MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036119508

License Status

ACTIVE

Business

First Name

TRAVIS

Middle

Last Name

BULLOCK

Suffix

Business Name

TRAVIS L BULLOCK MD

Original Issue Date

10/10/2007

Effective Date

06/09/2023

Expiration Date

07/31/2026

City

MARYVILLE

State

Zip

62062

County

MADISON

Ever Disciplined

LastModifiedDate

06/09/2023