PATRICK T PARK Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125027501

License Status

EXPIRED

Business

First Name

PATRICK

Middle

Last Name

PARK

Business Name

PATRICK T PARK

Original Issue Date

08/13/1991

Effective Date

08/13/1991

Expiration Date

07/30/1993

City

SPRINGFIELD

State

Zip

62794

County

SANGAMON

Specialty/Qualifier

Obstetrics & Gynecology

Ever Disciplined

LastModifiedDate

09/22/2006