KENTON LEE WATERBROOK Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036120878

License Status

NOT RENEWED

Business

First Name

KENTON

Middle

LEE

Last Name

WATERBROOK

Business Name

KENTON LEE WATERBROOK

Original Issue Date

05/15/2008

Effective Date

05/15/2008

Expiration Date

07/31/2011

City

WILLIAMSTON

State

Zip

48895

Ever Disciplined

LastModifiedDate

10/09/2013