JUSTIN RICHARD JOHNSON Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125054592

License Status

CANCELLED

Business

First Name

JUSTIN

Middle

RICHARD

Last Name

JOHNSON

Business Name

JUSTIN RICHARD JOHNSON

Original Issue Date

07/01/2008

Effective Date

07/01/2008

Expiration Date

06/30/2011

City

MONTICELLO

State

Zip

61856

County

PIATT

Specialty/Qualifier

Emergency Medicine

Ever Disciplined

LastModifiedDate

04/30/2008