GERALD WILLIAM MILLER MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125068177

License Status

CANCELLED

Business

Title

First Name

GERALD

Middle

WILLIAM

Last Name

MILLER

Business Name

GERALD WILLIAM MILLER MD

Original Issue Date

06/26/2016

Effective Date

06/26/2016

Expiration Date

06/25/2019

City

SPRINGFIELD

State

Zip

62701

County

SANGAMON

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

05/04/2016