CARL ROBERT JOHNSON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036057126

License Status

NOT RENEWED

Business

First Name

CARL ROBERT

Last Name

JOHNSON

Suffix

Business Name

CARL ROBERT JOHNSON MD

Original Issue Date

07/24/1978

Effective Date

07/24/2017

Expiration Date

09/30/2020

City

MATTOON

State

Zip

61938

County

COLES

Ever Disciplined

LastModifiedDate

01/14/2021