FREDERICK PAUL O'BRIEN III Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036148276

License Status

NOT RENEWED

Business

First Name

FREDERICK

Middle

PAUL

Last Name

O'BRIEN III

Business Name

FREDERICK PAUL O'BRIEN III

Original Issue Date

02/06/2019

Effective Date

02/06/2019

Expiration Date

09/30/2020

City

ROCKFORD

State

Zip

61103

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

01/14/2021