KENYATTA D NORMAN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****32

License Status

NOT RENEWED

Business

Title

First Name

KENYATTA

Middle

Last Name

NORMAN

Business Name

KENYATTA D NORMAN MD

Original Issue Date

08/25/2011

Effective Date

07/07/2014

Expiration Date

07/31/2017

City

ST LOUIS

State

Zip

62002

County

MISSOURI

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020