B KENT MAUPIN Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****47

License Status

NOT RENEWED

Business

First Name

B KENT

Last Name

MAUPIN

Business Name

B KENT MAUPIN

Original Issue Date

01/01/1997

Expiration Date

09/01/1982

City

EVANSTON

State

Zip

60203

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006