LOUIS KIENZLER GRAHAM MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****84

License Status

ACTIVE

Business

First Name

LOUIS

Middle

KIENZLER

Last Name

GRAHAM

Suffix

Business Name

LOUIS KIENZLER GRAHAM MD

Original Issue Date

03/22/2017

Effective Date

06/21/2023

Expiration Date

07/31/2026

City

SPRINGFIELD

State

Zip

62702

County

SANGAMON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/21/2023