RICHARD ELY BURGESS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036133825

License Status

NOT RENEWED

Business

Title

First Name

RICHARD

Middle

ELY

Last Name

BURGESS

Business Name

RICHARD ELY BURGESS MD

Original Issue Date

08/20/2013

Effective Date

06/05/2017

Expiration Date

09/30/2020

City

MOKENA

State

Zip

60448

County

WILL

Ever Disciplined

LastModifiedDate

01/14/2021