EDMUND KENNEDY MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****76

License Status

NOT RENEWED

Business

First Name

EDMUND

Last Name

KENNEDY

Suffix

Business Name

EDMUND KENNEDY MD

Original Issue Date

01/01/1997

Expiration Date

07/31/1984

City

MATTOON

State

Zip

61938

County

COLES

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006