KENNETH W BIRGE JR MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****71

License Status

NOT RENEWED

Business

First Name

KENNETH W

Last Name

BIRGE JR

Suffix

Business Name

KENNETH W BIRGE JR MD

Original Issue Date

06/16/1989

Effective Date

06/16/1989

Expiration Date

07/31/1996

City

LINCOLN

State

Zip

62656

County

LOGAN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020