TRENT D PROEHL Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125039961

License Status

EXPIRED

Business

First Name

TRENT

Middle

Last Name

PROEHL

Business Name

TRENT D PROEHL

Original Issue Date

07/01/1999

Effective Date

07/01/1999

Expiration Date

06/30/2004

City

PEORIA

State

Zip

61637

County

PEORIA

Specialty/Qualifier

General Surgery

Ever Disciplined

LastModifiedDate

09/22/2006