TROY P BERTOLI MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125048777

License Status

EXPIRED

Business

First Name

TROY

Middle

Last Name

BERTOLI

Suffix

Business Name

TROY P BERTOLI MD

Original Issue Date

08/02/2004

Effective Date

08/02/2004

Expiration Date

08/01/2007

City

SPRINGFIELD

State

Zip

62794

County

SANGAMON

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

08/29/2007