KIM DIANE HOLTMEIER MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****72

License Status

NOT RENEWED

Business

First Name

KIM

Middle

DIANE

Last Name

HOLTMEIER

Suffix

Business Name

KIM DIANE HOLTMEIER MD

Original Issue Date

11/30/2004

Effective Date

11/30/2004

Expiration Date

07/31/2008

City

PEORIA

State

Zip

61602

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/06/2008