KENNETH ALAN BUCKWALTER MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****02

License Status

NOT RENEWED

Business

First Name

KENNETH

Middle

ALAN

Last Name

BUCKWALTER

Suffix

Business Name

KENNETH ALAN BUCKWALTER MD

Original Issue Date

02/11/1997

Effective Date

02/11/1997

Expiration Date

07/31/1999

City

CHICAGO

State

Zip

60614

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/11/2017