KODY DUANE DORMIRE DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036162380

License Status

ACTIVE

Business

Title

First Name

KODY

Middle

DUANE

Last Name

DORMIRE

Business Name

KODY DUANE DORMIRE DO

Original Issue Date

09/16/2022

Effective Date

04/09/2023

Expiration Date

07/31/2026

City

PEORIA

State

Zip

61605

County

PEORIA

Ever Disciplined

LastModifiedDate

04/09/2023