PHILIP BUDIHARDJO DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036126043

License Status

ACTIVE

Business

First Name

PHILIP

Last Name

BUDIHARDJO

Suffix

Business Name

PHILIP BUDIHARDJO DO

Original Issue Date

06/10/2010

Effective Date

06/30/2023

Expiration Date

07/31/2026

City

ROSCOE

State

Zip

61073

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

12/24/2025