KENNETH A BERDICK MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****75

License Status

NOT RENEWED

Business

First Name

KENNETH A

Last Name

BERDICK

Suffix

Business Name

KENNETH A BERDICK MD

Original Issue Date

06/29/1981

Effective Date

06/29/1981

Expiration Date

09/01/1982

City

MATTOON

State

Zip

61938

County

COLES

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006