KIMBERLEY A HANNEKEN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****55

License Status

NOT RENEWED

Business

First Name

KIMBERLEY

Middle

Last Name

HANNEKEN

Suffix

Business Name

KIMBERLEY A HANNEKEN MD

Original Issue Date

04/24/1997

Effective Date

05/08/2017

Expiration Date

09/30/2020

City

UKIAH

State

Zip

95482

County

MACON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021

Case Number

1996010517

Action

Probation

Discipline Start Date

09/11/1996

Discipline End Date

04/14/1997

Discipline Reason

License issued and placed on probation due to a history of depression.