JASIRI KENNEDY MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****97

License Status

NOT RENEWED

Business

Title

First Name

JASIRI

Last Name

KENNEDY

Business Name

JASIRI KENNEDY MD

Original Issue Date

01/09/2002

Effective Date

01/09/2002

Expiration Date

07/31/2005

City

CARLINVILLE

State

Zip

62626

County

MACOUPIN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020