KELVIN L DOUGLAS Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125015121

License Status

EXPIRED

Business

First Name

KELVIN

Middle

Last Name

DOUGLAS

Business Name

KELVIN L DOUGLAS

Original Issue Date

01/21/1983

Effective Date

01/21/1983

Expiration Date

01/03/1985

City

NORTH CHICAGO

State

Zip

60064

County

LAKE

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006