KEVIN T DOOMS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****05

License Status

NOT RENEWED

Business

First Name

KEVIN

Middle

Last Name

DOOMS

Suffix

Business Name

KEVIN T DOOMS MD

Original Issue Date

01/18/2008

Effective Date

06/11/2008

Expiration Date

07/31/2011

City

MARYVILLE

State

Zip

62062

County

MADISON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/10/2011