BRYSON RICHARD ENSIGN DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125081396

License Status

ACTIVE

Business

Title

First Name

BRYSON

Middle

RICHARD

Last Name

ENSIGN

Business Name

BRYSON RICHARD ENSIGN DO

Original Issue Date

07/01/2023

Effective Date

07/01/2023

Expiration Date

06/30/2026

City

PEORIA

State

Zip

61605

County

PEORIA

Specialty/Qualifier

Psychiatry

Ever Disciplined

LastModifiedDate

04/26/2023