PHILLIP W JOHNSON MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125021111

License Status

EXPIRED

Business

First Name

PHILLIP W

Last Name

JOHNSON

Suffix

Business Name

PHILLIP W JOHNSON MD

Original Issue Date

06/02/1987

Effective Date

06/02/1987

Expiration Date

07/01/1990

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006