KEVIN M FAHEY Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125039094

License Status

EXPIRED

Business

First Name

KEVIN M

Last Name

FAHEY

Business Name

KEVIN M FAHEY

Original Issue Date

07/01/1999

Effective Date

07/01/1999

Expiration Date

07/16/2004

City

PEORIA

State

Zip

61637

County

PEORIA

Specialty/Qualifier

Diagnostic Radiology

Ever Disciplined

LastModifiedDate

09/22/2006