KENNETH DONALD KLEIST MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****66

License Status

CANCELLED

Business

First Name

KENNETH

Middle

DONALD

Last Name

KLEIST

Suffix

Business Name

KENNETH DONALD KLEIST MD

Original Issue Date

08/11/2005

Effective Date

08/11/2005

Expiration Date

07/31/2008

City

CHICAGO

State

Zip

60612

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/17/2008