BRENT C JOHNSON Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125035888

License Status

EXPIRED

Business

First Name

BRENT

Middle

Last Name

JOHNSON

Business Name

BRENT C JOHNSON

Original Issue Date

05/09/1997

Effective Date

05/09/1997

Expiration Date

06/30/2002

City

SPRINGFIELD

State

Zip

62794

County

SANGAMON

Specialty/Qualifier

Orthopaedic Surgery

Ever Disciplined

LastModifiedDate

09/22/2006