JASON ENSLEY KENNEDY MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****06

License Status

NOT RENEWED

Business

Title

First Name

JASON

Middle

ENSLEY

Last Name

KENNEDY

Business Name

JASON ENSLEY KENNEDY MD

Original Issue Date

06/25/2008

Effective Date

06/25/2008

Expiration Date

07/31/2011

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/10/2011