JOHN PATRICK REVORD MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036098463

License Status

INACTIVE

Business

First Name

JOHN

Middle

PATRICK

Last Name

REVORD

Suffix

Business Name

JOHN PATRICK REVORD MD

Original Issue Date

07/27/1998

Effective Date

07/27/1998

Expiration Date

07/31/1999

City

APPLETON

State

Zip

54912

County

WISCONSIN

Ever Disciplined

LastModifiedDate

09/20/2006