EMILY JANE BURDICK MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125052612

License Status

CANCELLED

Business

First Name

EMILY

Middle

JANE

Last Name

BURDICK

Suffix

Business Name

EMILY JANE BURDICK MD

Original Issue Date

07/01/2010

Effective Date

07/01/2010

Expiration Date

06/30/2012

City

PEORIA

State

Zip

61637

County

PEORIA

Specialty/Qualifier

Diagnostic Radiology

Ever Disciplined

LastModifiedDate

05/19/2010