KEVIN WAYNE STEPHENS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036118483

License Status

NOT RENEWED

Business

First Name

KEVIN

Middle

WAYNE

Last Name

STEPHENS

Suffix

Business Name

KEVIN WAYNE STEPHENS MD

Original Issue Date

05/24/2007

Effective Date

07/11/2011

Expiration Date

07/31/2014

City

CHARLESTON

State

Zip

61920

County

COLES

Ever Disciplined

LastModifiedDate

11/17/2014