SIMON KABUTUTWA MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125074862

License Status

CANCELLED

Business

Title

First Name

SIMON

Last Name

KABUTUTWA

Business Name

SIMON KABUTUTWA MD

Original Issue Date

07/01/2019

Effective Date

07/01/2019

Expiration Date

06/30/2022

City

PEORIA

State

Zip

61602

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

06/04/2019