ROBERT LLEWELLYN BURGESS MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125053103

License Status

EXPIRED

Business

First Name

ROBERT

Middle

LLEWELLYN

Last Name

BURGESS

Suffix

Business Name

ROBERT LLEWELLYN BURGESS MD

Original Issue Date

07/01/2007

Effective Date

07/01/2007

Expiration Date

06/30/2010

City

PEORIA

State

Zip

61637

County

PEORIA

Specialty/Qualifier

Diagnostic Radiology

Ever Disciplined

LastModifiedDate

07/08/2010