RANDY V KELLENBERGER DO Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036071173

License Status

INACTIVE

Business

First Name

RANDY V

Last Name

KELLENBERGER

Suffix

Business Name

RANDY V KELLENBERGER DO

Original Issue Date

07/11/1985

Effective Date

07/11/1985

Expiration Date

07/31/1987

City

WASHINGTON

State

Zip

61571

County

TAZEWELL

Ever Disciplined

LastModifiedDate

09/20/2006