KENNETH R GREEN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036048482

License Status

NOT RENEWED

Business

First Name

KENNETH R

Last Name

GREEN

Suffix

Business Name

KENNETH R GREEN MD

Original Issue Date

12/12/1973

Effective Date

12/12/1973

City

SYRACUSE

State

Zip

13202

County

NEW YORK

Ever Disciplined

LastModifiedDate

09/20/2006