KENNEN B THOMPSON Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

LIMITED MEDICAL TEMPORARY PERMIT

License Number

130000307

License Status

EXPIRED

Business

First Name

KENNEN

Middle

Last Name

THOMPSON

Business Name

KENNEN B THOMPSON

Original Issue Date

10/30/1995

Effective Date

10/30/1995

Expiration Date

12/31/1995

City

ROCKFORD

State

Zip

61107

County

BOONE

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/25/2006