KEVIN RAY DIEL MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125040785

License Status

CANCELLED

Business

First Name

KEVIN

Middle

RAY

Last Name

DIEL

Suffix

Business Name

KEVIN RAY DIEL MD

Original Issue Date

07/01/2000

Effective Date

07/01/2000

Expiration Date

06/30/2003

City

CARBONDALE

State

Zip

62901

County

JACKSON

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006