KENNETH R DORMAN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****32

License Status

NOT RENEWED

Business

First Name

KENNETH R

Last Name

DORMAN

Suffix

Business Name

KENNETH R DORMAN MD

Original Issue Date

06/30/1989

Effective Date

06/30/1989

Expiration Date

07/31/1996

City

HARRISBURG

State

Zip

62946

County

SALINE

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

09/26/2006