KRISTIN E CLEMONS Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****51

License Status

NOT RENEWED

Business

First Name

KRISTIN

Middle

Last Name

CLEMONS

Business Name

KRISTIN E CLEMONS

Original Issue Date

12/13/1999

Effective Date

05/19/2017

Expiration Date

09/30/2020

City

ROCKFORD

State

Zip

61103

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021