JONATHAN GEORGE BARDAHL DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125070431

License Status

EXPIRED

Business

Title

First Name

JONATHAN

Middle

GEORGE

Last Name

BARDAHL

Business Name

JONATHAN GEORGE BARDAHL DO

Original Issue Date

07/01/2017

Effective Date

07/01/2017

Expiration Date

06/30/2020

City

PEORIA

State

Zip

61605

County

PEORIA

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

11/19/2020