DENNIS OWEN BACKSTROM MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036058856

License Status

ACTIVE

Business

First Name

DENNIS OWEN

Last Name

BACKSTROM

Suffix

Business Name

DENNIS OWEN BACKSTROM MD

Original Issue Date

07/12/1979

Effective Date

04/14/2023

Expiration Date

07/31/2026

City

DUNLAP

State

Zip

61525

County

PEORIA

Ever Disciplined

LastModifiedDate

04/14/2023