NICOLE LYNETTE KENNEDY MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****00

License Status

ACTIVE

Business

Title

First Name

NICOLE

Middle

LYNETTE

Last Name

KENNEDY

Business Name

NICOLE LYNETTE KENNEDY MD

Original Issue Date

04/01/2013

Effective Date

06/02/2023

Expiration Date

07/31/2026

City

MARION

State

Zip

62959

County

WILLIAMSON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/02/2023