NIELS C ANDERSEN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036068067

License Status

NOT RENEWED

Business

First Name

NIELS C

Last Name

ANDERSEN

Suffix

Business Name

NIELS C ANDERSEN MD

Original Issue Date

12/15/1983

Effective Date

12/15/1983

Expiration Date

07/31/1987

City

PEORIA

State

Zip

61614

County

PEORIA

Ever Disciplined

LastModifiedDate

09/20/2006