KRISTINE ROSS CARPENTER MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****69

License Status

ACTIVE

Business

Title

First Name

KRISTINE

Middle

ROSS

Last Name

CARPENTER

Business Name

KRISTINE ROSS CARPENTER MD

Original Issue Date

03/21/2011

Effective Date

06/25/2023

Expiration Date

07/31/2026

City

MATTOON

State

Zip

61938

County

COLES

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/25/2023