KENNETH IVAN BLUESTONE MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****57

License Status

ACTIVE

Business

Title

First Name

KENNETH

Middle

IVAN

Last Name

BLUESTONE

Business Name

KENNETH IVAN BLUESTONE MD

Original Issue Date

07/30/2015

Effective Date

04/10/2023

Expiration Date

07/31/2026

City

BELLEVILLE

State

Zip

62226

County

SAINT CLAIR

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/10/2023