KENNETH J WAKEFIELD MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****43

License Status

NOT RENEWED

Business

First Name

KENNETH J

Last Name

WAKEFIELD

Suffix

Business Name

KENNETH J WAKEFIELD MD

Original Issue Date

08/11/1993

Effective Date

08/11/1993

Expiration Date

07/31/1996

City

BELLEVILLE

State

Zip

62223

County

SAINT CLAIR

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006