KENNETH J PHILLIPS JR MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****66

License Status

NOT RENEWED

Business

First Name

KENNETH J

Last Name

PHILLIPS JR

Suffix

Business Name

KENNETH J PHILLIPS JR MD

Original Issue Date

02/11/1988

Effective Date

02/11/1988

Expiration Date

07/31/1999

City

NASHVILLE

State

Zip

62263

County

WASHINGTON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006