KENNETH J WAKEFIELD MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****42

License Status

NOT RENEWED

Business

First Name

KENNETH J

Last Name

WAKEFIELD

Suffix

Business Name

KENNETH J WAKEFIELD MD

Original Issue Date

03/22/1990

Effective Date

03/22/1990

Expiration Date

07/31/2008

City

OFALLON

State

Zip

62269

County

SAINT CLAIR

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/06/2008