ADRIAN E BIFOM MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125079997

License Status

CANCELLED

Business

Title

First Name

ADRIAN

Middle

Last Name

BIFOM

Business Name

ADRIAN E BIFOM MD

Original Issue Date

06/26/2022

Effective Date

06/26/2022

Expiration Date

06/25/2025

City

SPRINGFIELD

State

Zip

62701

County

SANGAMON

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

12/11/2024