MARY M 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

First Name

MARY M

Last Name

KENNEDY

Suffix

Business Name

MARY M KENNEDY MD

Original Issue Date

07/02/1986

Effective Date

07/02/1986

Expiration Date

07/31/1987

City

ANNA

State

Zip

62906

County

UNION

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006