DAVID T GOUGH MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125016261

License Status

EXPIRED

Business

First Name

DAVID T

Last Name

GOUGH

Suffix

Business Name

DAVID T GOUGH MD

Original Issue Date

07/25/1983

Effective Date

07/25/1983

Expiration Date

07/01/1985

City

PEORIA

State

Zip

61637

County

PEORIA

Specialty/Qualifier

Emergency Medicine

Ever Disciplined

LastModifiedDate

09/22/2006