BRIAN WILLIAM HERRBOLD DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125042302

License Status

EXPIRED

Business

First Name

BRIAN

Middle

WILLIAM

Last Name

HERRBOLD

Suffix

Business Name

BRIAN WILLIAM HERRBOLD DO

Original Issue Date

07/01/2001

Effective Date

07/01/2001

Expiration Date

06/30/2004

City

PEORIA

State

Zip

61637

County

PEORIA

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

09/22/2006