JERALD J PHIPPS DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125022805

License Status

EXPIRED

Business

First Name

JERALD J

Last Name

PHIPPS

Suffix

Business Name

JERALD J PHIPPS DO

Original Issue Date

06/16/1988

Effective Date

06/16/1988

Expiration Date

07/01/1991

City

ROCKFORD

State

Zip

61107

County

BOONE

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006