GWENIVIERE KAYLA CAPRON MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125067567

License Status

CANCELLED

Business

Title

First Name

GWENIVIERE

Middle

KAYLA

Last Name

CAPRON

Business Name

GWENIVIERE KAYLA CAPRON MD

Original Issue Date

07/01/2018

Effective Date

07/01/2018

Expiration Date

06/30/2020

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Specialty/Qualifier

General Surgery

Ever Disciplined

LastModifiedDate

05/31/2018