KENNETH PATRICK DEPERSIO MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****81

License Status

NOT RENEWED

Business

First Name

KENNETH PATRICK

Last Name

DEPERSIO

Suffix

Business Name

KENNETH PATRICK DEPERSIO MD

Original Issue Date

01/01/1997

Expiration Date

07/31/2008

City

CHAMPAIGN

State

Zip

61820

County

CHAMPAIGN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/12/2017