GREGORY PAUL HAVERMALE DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125067324

License Status

EXPIRED

Business

Title

First Name

GREGORY

Middle

PAUL

Last Name

HAVERMALE

Business Name

GREGORY PAUL HAVERMALE DO

Original Issue Date

07/01/2018

Effective Date

07/01/2018

Expiration Date

06/30/2019

City

QUINCY

State

Zip

62301

County

ADAMS

Specialty/Qualifier

Sports Medicine (Family Practice)

Ever Disciplined

LastModifiedDate

10/02/2019