KENNETH R KROCK MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****17

License Status

ACTIVE

Business

First Name

KENNETH R

Last Name

KROCK

Suffix

Business Name

KENNETH R KROCK MD

Original Issue Date

08/22/1990

Effective Date

06/28/2023

Expiration Date

07/31/2026

City

CANTON

State

Zip

61520

County

FULTON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/28/2023