NICHOLAS STANWOOD KESSENER MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125071482

License Status

EXPIRED

Business

Title

First Name

NICHOLAS

Middle

STANWOOD

Last Name

KESSENER

Business Name

NICHOLAS STANWOOD KESSENER MD

Original Issue Date

07/01/2020

Effective Date

07/01/2020

Expiration Date

06/30/2021

City

PEORIA

State

Zip

61637

County

PEORIA

Specialty/Qualifier

Internal Medicine/Pediatrics

Ever Disciplined

LastModifiedDate

10/11/2022