KENNITH ALBERT MILLER DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036122466

License Status

NOT RENEWED

Business

Title

First Name

KENNITH

Middle

ALBERT

Last Name

MILLER

Business Name

KENNITH ALBERT MILLER DO

Original Issue Date

01/16/2009

Effective Date

01/16/2009

Expiration Date

07/31/2011

City

SPRING GREEN

State

Zip

53588

County

WISCONSIN

Ever Disciplined

LastModifiedDate

11/14/2011