KENNETH R BARBA Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036099756

License Status

ACTIVE

Business

First Name

KENNETH

Middle

Last Name

BARBA

Business Name

KENNETH R BARBA

Original Issue Date

03/03/1999

Effective Date

05/11/2023

Expiration Date

07/31/2026

City

BLOOMINGTON

State

Zip

61701

County

MCLEAN

Ever Disciplined

LastModifiedDate

05/11/2023