CHARLES RICHARD HEINZMANN III MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125072800

License Status

CANCELLED

Business

Title

First Name

CHARLES

Middle

RICHARD

Last Name

HEINZMANN

Suffix

III

Business Name

CHARLES RICHARD HEINZMANN III MD

Original Issue Date

07/01/2018

Effective Date

07/01/2018

Expiration Date

06/30/2021

City

PEORIA

State

Zip

61605

County

PEORIA

Specialty/Qualifier

Emergency Medicine

Ever Disciplined

LastModifiedDate

05/16/2018