KENNETH W NIPPS 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 W

Last Name

NIPPS

Business Name

KENNETH W NIPPS

Original Issue Date

03/15/1989

Effective Date

03/15/1989

Expiration Date

07/31/1996

City

ROCKFORD

State

Zip

61109

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006