PHILIP D WITKOP MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125034154

License Status

EXPIRED

Business

First Name

PHILIP

Middle

Last Name

WITKOP

Suffix

Business Name

PHILIP D WITKOP MD

Original Issue Date

05/08/1996

Effective Date

05/08/1996

Expiration Date

06/30/1999

City

SPRINGFIELD

State

Zip

62794

County

SANGAMON

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006