KEITH LEE MULLENGER MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****07

License Status

NOT RENEWED

Business

First Name

KEITH LEE

Last Name

MULLENGER

Suffix

Business Name

KEITH LEE MULLENGER MD

Original Issue Date

07/31/1996

Effective Date

07/31/1996

Expiration Date

07/31/2005

City

BELLEVILLE

State

Zip

62223

County

SAINT CLAIR

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006