BRIAN PECK FAWCETT MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036127310

License Status

NOT RENEWED

Business

Title

First Name

BRIAN

Middle

PECK

Last Name

FAWCETT

Business Name

BRIAN PECK FAWCETT MD

Original Issue Date

03/10/2011

Effective Date

05/09/2011

Expiration Date

07/31/2014

City

SPRINGFIELD

State

Zip

62711

County

SANGAMON

Ever Disciplined

LastModifiedDate

11/17/2014