KIRK DENNIS GREEN DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****96

License Status

NOT RENEWED

Business

First Name

KIRK

Middle

DENNIS

Last Name

GREEN

Suffix

Business Name

KIRK DENNIS GREEN DO

Original Issue Date

07/07/2005

Effective Date

08/01/2014

Expiration Date

07/31/2017

City

URBANDALE

State

Zip

50323

County

IOWA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017