TOM R BURCHAM JR MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036057854

License Status

INACTIVE

Business

First Name

TOM R

Last Name

BURCHAM JR

Suffix

Business Name

TOM R BURCHAM JR MD

Original Issue Date

10/05/1978

Effective Date

10/05/1978

Expiration Date

07/31/1987

City

FARMINGTON

State

Zip

63640

County

MISSOURI

Ever Disciplined

LastModifiedDate

09/20/2006