EMILY JANE BURDICK MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****97

License Status

NOT RENEWED

Business

First Name

EMILY

Middle

JANE

Last Name

BURDICK

Suffix

Business Name

EMILY JANE BURDICK MD

Original Issue Date

07/08/2010

Effective Date

05/02/2011

Expiration Date

07/31/2014

City

PEORIA

State

Zip

61604

County

PEORIA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014