RONALD BENJAMIN COLLINS JR MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125050346

License Status

CANCELLED

Business

First Name

RONALD

Middle

BENJAMIN

Last Name

COLLINS JR

Suffix

Business Name

RONALD BENJAMIN COLLINS JR MD

Original Issue Date

07/01/2005

Effective Date

07/01/2005

Expiration Date

06/30/2008

City

PEORIA

State

Zip

61637

County

PEORIA

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006