KERYL JEAN GREEN MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125034406

License Status

EXPIRED

Business

First Name

KERYL

Middle

JEAN

Last Name

GREEN

Suffix

Business Name

KERYL JEAN GREEN MD

Original Issue Date

05/16/1996

Effective Date

05/16/1996

Expiration Date

06/30/1999

City

BELLEVILLE

State

Zip

62220

County

SAINT CLAIR

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006