MARK RYAN PAPENFUSS DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125049736

License Status

CANCELLED

Business

First Name

MARK

Middle

RYAN

Last Name

PAPENFUSS

Suffix

Business Name

MARK RYAN PAPENFUSS DO

Original Issue Date

07/01/2008

Effective Date

07/01/2008

Expiration Date

06/30/2010

City

PEORIA

State

Zip

61605

County

PEORIA

Specialty/Qualifier

Diagnostic Radiology

Ever Disciplined

LastModifiedDate

06/11/2008