KENNETH GEORGE LIE MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125040056

License Status

CANCELLED

Business

First Name

KENNETH

Middle

GEORGE

Last Name

LIE

Suffix

Business Name

KENNETH GEORGE LIE MD

Original Issue Date

07/01/1999

Effective Date

07/01/1999

Expiration Date

06/30/2002

City

HAPPY VALLEY

State

Zip

97086

Specialty/Qualifier

Emergency Medicine

Ever Disciplined

LastModifiedDate

09/22/2006