KENNETH E CARPENTER Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125046050

License Status

NOT RENEWED

Business

First Name

KENNETH

Middle

Last Name

CARPENTER

Business Name

KENNETH E CARPENTER

Original Issue Date

07/01/2003

Effective Date

07/01/2003

Expiration Date

09/30/2006

City

PEORIA

State

Zip

61637

County

PEORIA

Specialty/Qualifier

Emergency Medicine

Ever Disciplined

LastModifiedDate

11/03/2006