KEKOA C EDE Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125037600

License Status

EXPIRED

Business

First Name

KEKOA

Middle

Last Name

EDE

Business Name

KEKOA C EDE

Original Issue Date

06/26/1998

Effective Date

06/26/1998

Expiration Date

06/25/2003

City

SPRINGFIELD

State

Zip

62794

County

SANGAMON

Ever Disciplined

LastModifiedDate

09/22/2006