LANA JEAN DAVENPORT MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

VISITING RESIDENT

License Number

188000182

License Status

EXPIRED

Business

First Name

LANA

Middle

JEAN

Last Name

DAVENPORT

Suffix

Business Name

LANA JEAN DAVENPORT MD

Original Issue Date

11/01/2002

Effective Date

11/01/2002

Expiration Date

04/30/2003

City

BELLEVILLE

State

Zip

62226

Specialty/Qualifier

Pathology

Ever Disciplined

LastModifiedDate

09/25/2006