KELLY RAPHAEL NELSON MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036133801

License Status

INACTIVE

Business

Title

First Name

KELLY

Middle

RAPHAEL

Last Name

NELSON

Business Name

KELLY RAPHAEL NELSON MD

Original Issue Date

08/16/2013

Effective Date

08/16/2013

Expiration Date

07/31/2014

City

BRIDGEPORT

State

Zip

26330

County

WEST VIRGINIA

Ever Disciplined

LastModifiedDate

04/08/2014