KENNTH DAVID ILLINGWORTH MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125061286

License Status

EXPIRED

Business

Title

First Name

KENNTH

Middle

DAVID

Last Name

ILLINGWORTH

Business Name

KENNTH DAVID ILLINGWORTH MD

Original Issue Date

06/26/2015

Effective Date

06/26/2015

Expiration Date

06/25/2017

City

SPRINGFIELD

State

Zip

62701

County

SANGAMON

Specialty/Qualifier

Orthopaedic Surgery

Ever Disciplined

LastModifiedDate

09/19/2017