KEVIN LEE WALTZ MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036084474

License Status

INACTIVE

Business

First Name

KEVIN LEE

Last Name

WALTZ

Suffix

Business Name

KEVIN LEE WALTZ MD

Original Issue Date

06/05/1992

Effective Date

06/05/1992

Expiration Date

07/31/1996

City

INDIANAPOLIS

State

Zip

46256

County

INDIANA

Ever Disciplined

LastModifiedDate

09/20/2006