KENTON LEE MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****77

License Status

INACTIVE

Business

First Name

KENTON

Last Name

LEE

Suffix

Business Name

KENTON LEE MD

Original Issue Date

12/19/2014

Effective Date

07/20/2020

Expiration Date

07/31/2023

City

ROCKFORD

State

Zip

61102

County

WINNEBAGO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2023