KENNETH STEVENS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****67

License Status

NOT RENEWED

Business

First Name

KENNETH

Last Name

STEVENS

Suffix

Business Name

KENNETH STEVENS MD

Original Issue Date

06/06/1991

Effective Date

06/06/1991

Expiration Date

07/31/2008

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/06/2008