SETH GREGORY VAN HEUKELOM DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125067831

License Status

CANCELLED

Business

Title

First Name

SETH

Middle

GREGORY

Last Name

VAN HEUKELOM

Business Name

SETH GREGORY VAN HEUKELOM DO

Original Issue Date

07/01/2015

Effective Date

07/01/2015

Expiration Date

06/30/2018

City

PEORIA

State

Zip

61605

County

PEORIA

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

06/24/2015