M DALE KINZIE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****85

License Status

NOT RENEWED

Business

First Name

M DALE

Last Name

KINZIE

Suffix

Business Name

M DALE KINZIE MD

Original Issue Date

01/11/1982

Effective Date

01/11/1982

Expiration Date

07/31/1984

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006