CHRISTOPHER W MODERT DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125022928

License Status

EXPIRED

Business

First Name

CHRISTOPHER W

Last Name

MODERT

Suffix

Business Name

CHRISTOPHER W MODERT DO

Original Issue Date

06/29/1988

Effective Date

06/29/1988

Expiration Date

07/01/1991

City

PEORIA

State

Zip

61603

County

PEORIA

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006