KENNETH IVAN BLUESTONE MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036138832

License Status

ACTIVE

Business

Title

First Name

KENNETH

Middle

IVAN

Last Name

BLUESTONE

Business Name

KENNETH IVAN BLUESTONE MD

Original Issue Date

07/30/2015

Effective Date

04/10/2023

Expiration Date

07/31/2026

City

SAINT LOUIS

State

Zip

63141

Ever Disciplined

LastModifiedDate

04/10/2023