JUSTIN R JOHNSEN MD - Medical Doctor License in Utah | # 33*****17

JUSTIN R JOHNSEN MD

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****17

License Status

NOT RENEWED

Business

N

Title

MD

First Name

JUSTIN

Middle

R

Last Name

JOHNSEN

Business Name

JUSTIN R JOHNSEN MD

Original Issue Date

10/13/2015

Effective Date

06/12/2017

Expiration Date

09/30/2020

State

UT

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

N

LastModifiedDate

01/14/2021