KENNETH ROBERT DAVIS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036040396

License Status

NOT RENEWED

Business

First Name

KENNETH ROBERT

Last Name

DAVIS

Suffix

Business Name

KENNETH ROBERT DAVIS MD

Original Issue Date

07/05/1966

Effective Date

06/25/2008

Expiration Date

07/31/2011

City

WOODSTOCK

State

Zip

05091

Ever Disciplined

LastModifiedDate

11/14/2011