KENNETH WAYNE ALTMAN MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****36

License Status

CANCELLED

Business

First Name

KENNETH

Middle

WAYNE

Last Name

ALTMAN

Suffix

Business Name

KENNETH WAYNE ALTMAN MD

Original Issue Date

06/22/1999

Effective Date

06/22/1999

Expiration Date

07/31/2005

City

CHICAGO

State

Zip

60611

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006