DAVID JANTZEN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036138159

License Status

NOT RENEWED

Business

Title

First Name

DAVID

Last Name

JANTZEN

Business Name

DAVID JANTZEN MD

Original Issue Date

06/03/2015

Effective Date

06/01/2017

Expiration Date

09/30/2020

City

PEORIA

State

Zip

61603

County

PEORIA

Ever Disciplined

LastModifiedDate

01/14/2021