GREGORY W KELM Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085000042

License Status

NOT RENEWED

Business

First Name

GREGORY W

Last Name

KELM

Business Name

GREGORY W KELM

Original Issue Date

11/05/1980

Effective Date

11/05/1980

Expiration Date

11/05/1982

City

BELVIDERE

State

Zip

61008

County

BOONE

Ever Disciplined

LastModifiedDate

09/26/2006