KEITH LEE MULLENGER MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036061227

License Status

NOT RENEWED

Business

First Name

KEITH LEE

Last Name

MULLENGER

Suffix

Business Name

KEITH LEE MULLENGER MD

Original Issue Date

11/12/1980

Effective Date

11/12/1980

Expiration Date

07/31/2005

City

BELLEVILLE

State

Zip

62226

County

SAINT CLAIR

Ever Disciplined

LastModifiedDate

10/09/2006