MARK H GOERGEN MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125016423

License Status

EXPIRED

Business

First Name

MARK H

Last Name

GOERGEN

Suffix

Business Name

MARK H GOERGEN MD

Original Issue Date

10/12/1983

Effective Date

10/12/1983

Expiration Date

10/06/1985

City

PEORIA

State

Zip

61637

County

PEORIA

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006