GEORGIA LEE KETCHUM-STREET MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036166464

License Status

ACTIVE

Business

Title

First Name

GEORGIA

Middle

LEE

Last Name

KETCHUM-STREET

Business Name

GEORGIA LEE KETCHUM-STREET MD

Original Issue Date

08/11/2023

Effective Date

08/11/2023

Expiration Date

07/31/2026

City

PENSACOLA

State

Zip

32504

Ever Disciplined

LastModifiedDate

07/15/2023