EDGAR L KOCH MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036108001

License Status

NOT RENEWED

Business

First Name

EDGAR

Middle

Last Name

KOCH

Suffix

Business Name

EDGAR L KOCH MD

Original Issue Date

10/11/2002

Effective Date

07/31/2006

Expiration Date

07/31/2008

City

KENOSHA

State

Zip

53144

Ever Disciplined

LastModifiedDate

11/06/2008