DIRK R DEHAAS MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****55

License Status

ACTIVE

Business

First Name

DIRK

Middle

Last Name

DEHAAS

Suffix

Business Name

DIRK R DEHAAS MD

Original Issue Date

09/25/2007

Effective Date

04/12/2023

Expiration Date

07/31/2026

City

SAN JUAN CAPISTRANO

State

Zip

92675

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/12/2023