KELLY BETH HEIDLE DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125064186

License Status

EXPIRED

Business

First Name

KELLY

Middle

BETH

Last Name

HEIDLE

Suffix

Business Name

KELLY BETH HEIDLE DO

Original Issue Date

07/01/2013

Effective Date

07/01/2013

Expiration Date

06/30/2016

City

KANKAKEE

State

Zip

60901

County

KANKAKEE

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

08/16/2016