KENNETH WAYNE MARTIN DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

VISITING RESIDENT

License Number

188000571

License Status

EXPIRED

Business

Title

First Name

KENNETH

Middle

WAYNE

Last Name

MARTIN

Business Name

KENNETH WAYNE MARTIN DO

Original Issue Date

07/01/2015

Effective Date

07/01/2015

Expiration Date

12/31/2015

City

ROCK ISLAND

State

Zip

61201

County

ROCK ISLAND

Specialty/Qualifier

Family Practice

Ever Disciplined

LastModifiedDate

06/10/2016