JONATHAN ROGER KIRKWOOD MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****58

License Status

NOT RENEWED

Business

Title

First Name

JONATHAN

Middle

ROGER

Last Name

KIRKWOOD

Business Name

JONATHAN ROGER KIRKWOOD MD

Original Issue Date

08/03/2011

Effective Date

05/20/2014

Expiration Date

07/31/2017

City

SPRINGFIELD

State

Zip

62703

County

SANGAMON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017