KYLE JOSEPH HENNEBERRY MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036117425

License Status

NOT RENEWED

Business

First Name

KYLE

Middle

JOSEPH

Last Name

HENNEBERRY

Suffix

Business Name

KYLE JOSEPH HENNEBERRY MD

Original Issue Date

01/08/2007

Effective Date

09/14/2020

Expiration Date

07/31/2023

City

BOTHELL

State

Zip

98021

County

IDAHO

Ever Disciplined

LastModifiedDate

11/30/2023