ERIC THOMAS CULP DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125048550

License Status

CANCELLED

Business

First Name

ERIC

Middle

THOMAS

Last Name

CULP

Suffix

Business Name

ERIC THOMAS CULP DO

Original Issue Date

06/22/2004

Effective Date

06/22/2004

Expiration Date

06/21/2007

City

ROCKFORD

State

Zip

61104

County

WINNEBAGO

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

07/25/2007