CARMON LENZIE GLOVER III DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125034109

License Status

EXPIRED

Business

First Name

CARMON

Middle

LENZIE

Last Name

GLOVER

Suffix

III DO

Business Name

CARMON LENZIE GLOVER III DO

Original Issue Date

05/04/1996

Effective Date

05/04/1996

Expiration Date

06/30/1999

City

PEORIA

State

Zip

61637

County

PEORIA

Specialty/Qualifier

Emergency Medicine

Ever Disciplined

LastModifiedDate

09/22/2006