JUSTIN R JOHNSEN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036139244

License Status

NOT RENEWED

Business

Title

First Name

JUSTIN

Middle

Last Name

JOHNSEN

Business Name

JUSTIN R JOHNSEN MD

Original Issue Date

10/13/2015

Effective Date

06/07/2017

Expiration Date

09/30/2020

City

SPRINGFIELD

State

Zip

62704

County

SANGAMON

Ever Disciplined

LastModifiedDate

01/14/2021