KENNETH MORRIS SUSSMAN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****10

License Status

NOT RENEWED

Business

First Name

KENNETH MORRIS

Last Name

SUSSMAN

Suffix

Business Name

KENNETH MORRIS SUSSMAN MD

Original Issue Date

07/20/2004

Effective Date

06/30/2008

Expiration Date

07/31/2011

City

WATSEKA

State

Zip

60970

County

IROQUOIS

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/10/2011