EDWARD LOUIS BURKHALTER MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****26

License Status

NOT RENEWED

Business

First Name

EDWARD

Middle

LOUIS

Last Name

BURKHALTER

Suffix

Business Name

EDWARD LOUIS BURKHALTER MD

Original Issue Date

02/19/2003

Effective Date

07/14/2008

Expiration Date

07/31/2011

City

ROCKFORD

State

Zip

61103

County

WINNEBAGO

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

11/10/2011