KEVIN L KONZEN 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

KEVIN L

Last Name

KONZEN

Suffix

Business Name

KEVIN L KONZEN MD

Original Issue Date

12/13/1990

Effective Date

05/21/2014

Expiration Date

07/31/2017

City

EDWARDSVILLE

State

Zip

62025

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020