KELSEY MARIE LEVAULT MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125072817

License Status

CANCELLED

Business

Title

First Name

KELSEY

Middle

MARIE

Last Name

LEVAULT

Business Name

KELSEY MARIE LEVAULT MD

Original Issue Date

06/26/2018

Effective Date

06/26/2018

Expiration Date

06/25/2021

City

SPRINGFIELD

State

Zip

62701

County

SANGAMON

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

06/05/2018