KENNETH WILLIAM FRASER MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****96

License Status

ACTIVE

Business

First Name

KENNETH WILLIAM

Last Name

FRASER

Suffix

Business Name

KENNETH WILLIAM FRASER MD

Original Issue Date

07/05/1994

Effective Date

07/08/2023

Expiration Date

07/31/2026

City

EAST PEORIA

State

Zip

61611

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/08/2023