KENNETH THOMAS BELLIAN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****41

License Status

NOT RENEWED

Business

Title

First Name

KENNETH

Middle

THOMAS

Last Name

BELLIAN

Business Name

KENNETH THOMAS BELLIAN MD

Original Issue Date

10/06/2011

Effective Date

10/06/2011

Expiration Date

07/31/2014

City

ROCKFORD

State

Zip

61103

County

WINNEBAGO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020