AMANDA LYNN BETHEL WHALEY DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125065241

License Status

CANCELLED

Business

Title

First Name

AMANDA

Middle

LYNN BETHEL

Last Name

WHALEY

Business Name

AMANDA LYNN BETHEL WHALEY DO

Original Issue Date

07/01/2015

Effective Date

07/01/2015

Expiration Date

06/30/2017

City

NORMAL

State

Zip

61761

County

MCLEAN

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

01/19/2016