KUMPOL DENNISON MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036045819

License Status

INACTIVE

Business

First Name

KUMPOL

Last Name

DENNISON

Suffix

Business Name

KUMPOL DENNISON MD

Original Issue Date

07/31/1972

Effective Date

07/31/1972

Expiration Date

07/31/1990

City

VALPARAISO

State

Zip

46383

County

INDIANA

Ever Disciplined

LastModifiedDate

07/12/2016