LILY TADAYYON KREGENOW 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

LILY

Middle

TADAYYON

Last Name

KREGENOW

Suffix

Business Name

LILY TADAYYON KREGENOW MD

Original Issue Date

08/16/2002

Effective Date

08/16/2002

Expiration Date

07/31/2005

City

ALTON

State

Zip

62002

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006