EDWARD LOUIS BURKHALTER MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****07

License Status

CANCELLED

Business

First Name

EDWARD

Middle

LOUIS

Last Name

BURKHALTER

Suffix

Business Name

EDWARD LOUIS BURKHALTER MD

Original Issue Date

10/18/2005

Effective Date

07/14/2008

Expiration Date

07/31/2011

City

SPRINGFIELD

State

Zip

62702

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2011