KENNETH STEVENS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****68

License Status

NOT RENEWED

Business

First Name

KENNETH

Last Name

STEVENS

Suffix

Business Name

KENNETH STEVENS MD

Original Issue Date

09/23/1991

Effective Date

09/23/1991

Expiration Date

07/31/1993

City

PEORIA

State

Zip

61614

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006