KENNETH J WAKEFIELD MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036079751

License Status

NOT RENEWED

Business

First Name

KENNETH J

Last Name

WAKEFIELD

Suffix

Business Name

KENNETH J WAKEFIELD MD

Original Issue Date

03/02/1990

Effective Date

07/31/2006

Expiration Date

07/31/2008

City

COEUR D ALENE

State

Zip

83815

Ever Disciplined

LastModifiedDate

11/06/2008