LENNEY GEORGE KIZHAKEPUNNUR MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****97

License Status

ACTIVE

Business

Title

First Name

LENNEY

Middle

GEORGE

Last Name

KIZHAKEPUNNUR

Business Name

LENNEY GEORGE KIZHAKEPUNNUR MD

Original Issue Date

05/11/2012

Effective Date

07/11/2023

Expiration Date

07/31/2026

City

LOVES PARK

State

Zip

61111

County

WINNEBAGO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/19/2024