CLIFFORD RICHARD PEDDICORD MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036038901

License Status

NOT RENEWED

Business

First Name

CLIFFORD RICHARD

Last Name

PEDDICORD

Suffix

Business Name

CLIFFORD RICHARD PEDDICORD MD

Original Issue Date

01/10/1964

Effective Date

04/17/2008

Expiration Date

07/31/2011

City

KENOSHA

State

Zip

53142

County

WISCONSIN

Ever Disciplined

LastModifiedDate

11/14/2011