KENWORTH F HOLNESS Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****55

License Status

NOT RENEWED

Business

First Name

KENWORTH F

Last Name

HOLNESS

Business Name

KENWORTH F HOLNESS

Original Issue Date

04/17/1996

Effective Date

04/17/1996

Expiration Date

07/31/1999

City

ROCKFORD

State

Zip

61103

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006