THEODORE H SCHOCK DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125032613

License Status

EXPIRED

Business

First Name

THEODORE H

Last Name

SCHOCK

Suffix

Business Name

THEODORE H SCHOCK DO

Original Issue Date

05/23/1995

Effective Date

05/23/1995

Expiration Date

06/20/1998

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006