KEVIN RENARD TEAL MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****87

License Status

NOT RENEWED

Business

Title

First Name

KEVIN

Middle

RENARD

Last Name

TEAL

Business Name

KEVIN RENARD TEAL MD

Original Issue Date

01/16/2014

Effective Date

01/16/2014

Expiration Date

07/31/2014

City

QUINCY

State

Zip

62301

County

ADAMS

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020