EDWARD SAMUEL ROBERTO MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125083172

License Status

ACTIVE

Business

Title

First Name

EDWARD

Middle

SAMUEL

Last Name

ROBERTO

Business Name

EDWARD SAMUEL ROBERTO MD

Original Issue Date

07/01/2024

Effective Date

07/01/2024

Expiration Date

06/30/2027

City

PEORIA

State

Zip

61605

County

PEORIA

Specialty/Qualifier

General Surgery

Ever Disciplined

LastModifiedDate

04/06/2024