KENYATTA JAMAL FRAZIER MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****23

License Status

ACTIVE

Business

Title

First Name

KENYATTA

Middle

JAMAL

Last Name

FRAZIER

Business Name

KENYATTA JAMAL FRAZIER MD

Original Issue Date

07/10/2014

Effective Date

04/11/2023

Expiration Date

07/31/2026

City

TRAVERSE CITY

State

Zip

49696

County

TEXAS

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/11/2023