SUSAN J BURGE DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****80

License Status

NOT RENEWED

Business

First Name

SUSAN

Middle

Last Name

BURGE

Suffix

Business Name

SUSAN J BURGE DO

Original Issue Date

12/20/2007

Effective Date

06/24/2014

Expiration Date

07/31/2017

City

SPRINGFIELD

State

Zip

62704

County

SANGAMON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020