KIMBERLY M GLOW Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****56

License Status

NOT RENEWED

Business

First Name

KIMBERLY

Middle

Last Name

GLOW

Business Name

KIMBERLY M GLOW

Original Issue Date

08/08/2002

Effective Date

07/11/2017

Expiration Date

09/30/2020

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021