KYLE DEWEY HART MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125073263

License Status

CANCELLED

Business

Title

First Name

KYLE

Middle

DEWEY

Last Name

HART

Business Name

KYLE DEWEY HART MD

Original Issue Date

06/26/2021

Effective Date

06/26/2021

Expiration Date

06/25/2023

City

SPRINGFIELD

State

Zip

62701

County

SANGAMON

Specialty/Qualifier

Urology

Ever Disciplined

LastModifiedDate

01/19/2021