KEVIN WAYNE STEPHENS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****35

License Status

NOT RENEWED

Business

First Name

KEVIN

Middle

WAYNE

Last Name

STEPHENS

Suffix

Business Name

KEVIN WAYNE STEPHENS MD

Original Issue Date

05/24/2007

Effective Date

07/11/2011

Expiration Date

07/31/2014

City

CHARLESTON

State

Zip

61920

County

COLES

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014