KENNITH ALBERT MILLER DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****14

License Status

NOT RENEWED

Business

Title

First Name

KENNITH

Middle

ALBERT

Last Name

MILLER

Business Name

KENNITH ALBERT MILLER DO

Original Issue Date

01/21/2009

Effective Date

01/21/2009

Expiration Date

07/31/2011

City

PEKIN

State

Zip

61554

County

TAZEWELL

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/10/2011