LOUIS KIENZLER GRAHAM MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125061962

License Status

EXPIRED

Business

First Name

LOUIS

Middle

KIENZLER

Last Name

GRAHAM

Suffix

Business Name

LOUIS KIENZLER GRAHAM MD

Original Issue Date

06/26/2012

Effective Date

06/26/2012

Expiration Date

06/25/2013

City

SPRINGFIELD

State

Zip

62702

County

SANGAMON

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

10/07/2013