KEVIN DALE DRAXINGER MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****63

License Status

NOT RENEWED

Business

First Name

KEVIN

Middle

DALE

Last Name

DRAXINGER

Suffix

Business Name

KEVIN DALE DRAXINGER MD

Original Issue Date

05/25/2004

Effective Date

05/25/2004

Expiration Date

07/31/2008

City

MORRIS

State

Zip

60450

County

GRUNDY

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020