KENNETH EUGENE AMBROSE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****11

License Status

NOT RENEWED

Business

First Name

KENNETH EUGENE

Last Name

AMBROSE

Suffix

Business Name

KENNETH EUGENE AMBROSE MD

Original Issue Date

01/01/1997

Expiration Date

07/31/2005

City

MONMOUTH

State

Zip

61462

County

WARREN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006