KENNETH J KAVANAUGH DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125021660

License Status

EXPIRED

Business

First Name

KENNETH J

Last Name

KAVANAUGH

Suffix

Business Name

KENNETH J KAVANAUGH DO

Original Issue Date

08/04/1987

Effective Date

08/04/1987

Expiration Date

06/22/1990

City

LAGRANGE

State

Zip

60525

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006