ADAM WILLIAM BERRY MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125066869

License Status

CANCELLED

Business

Title

First Name

ADAM

Middle

WILLIAM

Last Name

BERRY

Business Name

ADAM WILLIAM BERRY MD

Original Issue Date

06/26/2018

Effective Date

06/26/2018

Expiration Date

06/25/2019

City

SPRINGFIELD

State

Zip

62701

County

SANGAMON

Specialty/Qualifier

Dermatology

Ever Disciplined

LastModifiedDate

03/26/2018