CHRISTIAN BERNARD BUMANGLAG AGBISIT MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125071039

License Status

CANCELLED

Business

Title

First Name

CHRISTIAN BERNARD

Middle

BUMANGLAG

Last Name

AGBISIT

Business Name

CHRISTIAN BERNARD BUMANGLAG AGBISIT MD

Original Issue Date

06/26/2017

Effective Date

06/26/2017

Expiration Date

06/25/2020

City

SPRINGFIELD

State

Zip

62701

County

SANGAMON

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

05/15/2017