KEVIN THOMAS POWELL MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****70

License Status

NOT RENEWED

Business

First Name

KEVIN

Middle

THOMAS

Last Name

POWELL

Suffix

Business Name

KEVIN THOMAS POWELL MD

Original Issue Date

05/06/1996

Effective Date

05/29/2007

Expiration Date

07/31/2008

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/06/2008