KENNETH J RENNER MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****00

License Status

NOT RENEWED

Business

First Name

KENNETH J

Last Name

RENNER

Suffix

Business Name

KENNETH J RENNER MD

Original Issue Date

07/15/1996

Effective Date

06/10/2008

Expiration Date

07/31/2011

City

GIBSON CITY

State

Zip

60936

County

FORD

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/10/2011