MARK J HEINZELMANN Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125021137

License Status

EXPIRED

Business

First Name

MARK

Middle

Last Name

HEINZELMANN

Business Name

MARK J HEINZELMANN

Original Issue Date

06/03/1987

Effective Date

06/03/1987

Expiration Date

07/01/1990

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Specialty/Qualifier

Colon & Rectal Surgery

Ever Disciplined

LastModifiedDate

09/22/2006