KENNETH E CARPENTER Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****06

License Status

ACTIVE

Business

First Name

KENNETH

Middle

Last Name

CARPENTER

Business Name

KENNETH E CARPENTER

Original Issue Date

10/10/2006

Effective Date

06/21/2023

Expiration Date

07/31/2026

City

HANNA CITY

State

Zip

61536

County

PEORIA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/21/2023