KELLY E BEWSEY Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125039601

License Status

EXPIRED

Business

First Name

KELLY

Middle

Last Name

BEWSEY

Business Name

KELLY E BEWSEY

Original Issue Date

07/01/1999

Effective Date

07/01/1999

Expiration Date

06/30/2004

City

SPRINGFIELD

State

Zip

62794

County

SANGAMON

Specialty/Qualifier

Urology

Ever Disciplined

LastModifiedDate

09/22/2006