KENNETH D PHILLIPS JR MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125026832

License Status

EXPIRED

Business

First Name

KENNETH D

Last Name

PHILLIPS JR

Suffix

Business Name

KENNETH D PHILLIPS JR MD

Original Issue Date

05/20/1991

Effective Date

05/20/1991

Expiration Date

06/30/1994

City

PEORIA

State

Zip

61603

County

PEORIA

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006