TRACEY D KINIGAKIS 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

TRACEY

Middle

Last Name

KINIGAKIS

Suffix

Business Name

TRACEY D KINIGAKIS MD

Original Issue Date

04/14/1997

Effective Date

07/18/2011

Expiration Date

07/31/2014

City

POPLAR GROVE

State

Zip

61065

County

BOONE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/12/2017