| | Physician Last Name: | Edstrom |
| | Physician First Name: | Kenneth |
| | Physician Middle Name: | |
| | Address: | Address redacted |
| | License Number: | 176773 |
| | License Type: | MD |
| | Year of Birth: |
1955
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| | Effective Date: | 03/16/2021 |
| | Action Description for DOH Webpage: | License limitation precluding the registration or issuance of any further New York State medical license. The physician is precluded from practicing medicine in New York State and from practicing in any setting where his practice is based solely on his New York State medical license. The physician is also precluded from further reliance upon his New York State medical license to exempt him from the licensure, certification or other requirements set forth in statute or regulation for the practice of any other profession licensed, regulated or certified by the New York State Board of Regents, New York State Department of Education, New York State Department of Health or the New York State Department of State. |
| | Misconduct Description for DOH Webpage: | The physician did not contest the charge of committing professional misconduct by having been disciplined by the State of Washington Department of Health under sections of their law which would constitute conduct which evidenced moral unfitness to practice medicine; willfully making or filing a false report; and willfully harassing, abusing or intimidating a patient either physically or verbally under the laws of New York State. |
| | License Limitations or Conditions for DOH Webpage: | License limitation precluding the registration or issuance of any further New York State medical license. The physician is precluded from practicing medicine in New York State and from practicing in any setting where his practice is based solely on his New York State medical license. The physician is also precluded from further reliance upon his New York State medical license to exempt him from the licensure, certification or other requirements set forth in statute or regulation for the practice of any other profession licensed, regulated or certified by the New York State Board of Regents, New York State Department of Education, New York State Department of Health or the New York State Department of State. |
| | Board Order: |
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