HAZEN HENRY TUCK MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125051004

License Status

EXPIRED

Business

First Name

HAZEN

Middle

HENRY

Last Name

TUCK

Suffix

Business Name

HAZEN HENRY TUCK MD

Original Issue Date

07/01/2006

Effective Date

07/01/2006

Expiration Date

06/30/2009

City

PEORIA

State

Zip

61637

County

PEORIA

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/13/2011