KELLY MARIE KASUM DVM Veterinarian License verification

Business Entity

NOT RENEWED

License Type

Veterinarian

Description

LICENSED VETERINARIAN CONTROLLED SUBSTANCE

License Number

39*****52

License Status

NOT RENEWED

Business

First Name

KELLY

Middle

MARIE

Last Name

KASUM

Suffix

DVM

Business Name

KELLY MARIE KASUM DVM

Original Issue Date

09/17/1998

Effective Date

09/17/1998

Expiration Date

01/31/1999

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005