JASON KYLE WADDELL DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125052081

License Status

EXPIRED

Business

First Name

JASON

Middle

KYLE

Last Name

WADDELL

Suffix

Business Name

JASON KYLE WADDELL DO

Original Issue Date

07/01/2009

Effective Date

07/01/2009

Expiration Date

06/30/2012

City

NORMAL

State

Zip

61761

County

MCLEAN

Specialty/Qualifier

Neurological Surgery

Ever Disciplined

LastModifiedDate

08/29/2012