BRIAN PHILLIP DAHL MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125054596

License Status

EXPIRED

Business

Title

First Name

BRIAN

Middle

PHILLIP

Last Name

DAHL

Business Name

BRIAN PHILLIP DAHL MD

Original Issue Date

06/30/2011

Effective Date

06/30/2011

Expiration Date

06/29/2014

City

SPRINGFIELD

State

Zip

62701

County

SANGAMON

Specialty/Qualifier

Orthopaedic Surgery

Ever Disciplined

LastModifiedDate

03/13/2015