KENDRICK DEWAYNE JOHNSON MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125063144

License Status

EXPIRED

Business

Title

First Name

KENDRICK

Middle

DEWAYNE

Last Name

JOHNSON

Business Name

KENDRICK DEWAYNE JOHNSON MD

Original Issue Date

07/01/2019

Effective Date

07/01/2019

Expiration Date

06/30/2020

City

PEORIA

State

Zip

61605

County

PEORIA

Specialty/Qualifier

Neurological Surgery

Ever Disciplined

LastModifiedDate

11/19/2020