ROSS DAVID PERCELL DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125074034

License Status

CANCELLED

Business

Title

First Name

ROSS

Middle

DAVID

Last Name

PERCELL

Business Name

ROSS DAVID PERCELL DO

Original Issue Date

07/01/2019

Effective Date

07/01/2019

Expiration Date

06/30/2022

City

PEORIA

State

Zip

61615

County

PEORIA

Specialty/Qualifier

Emergency Medicine

Ever Disciplined

LastModifiedDate

04/30/2019