HENRY J KONZELMANN Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125032963

License Status

EXPIRED

Business

First Name

HENRY J

Last Name

KONZELMANN

Business Name

HENRY J KONZELMANN

Original Issue Date

06/03/1995

Effective Date

06/03/1995

Expiration Date

06/30/1998

City

CARBONDALE

State

Zip

62901

County

JACKSON

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006