ROBERT T KISKADDON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****25

License Status

NOT RENEWED

Business

First Name

ROBERT

Middle

Last Name

KISKADDON

Suffix

Business Name

ROBERT T KISKADDON MD

Original Issue Date

08/14/2001

Effective Date

06/04/2008

Expiration Date

07/31/2011

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/10/2011