NEILLY ANN BUCKALEW MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036151037

License Status

NOT RENEWED

Business

Title

First Name

NEILLY

Middle

ANN

Last Name

BUCKALEW

Business Name

NEILLY ANN BUCKALEW MD

Original Issue Date

10/18/2019

Effective Date

10/18/2019

Expiration Date

09/30/2020

City

HAUSER

State

Zip

83854

Ever Disciplined

LastModifiedDate

01/14/2021