CHAD RICHARD MARTENS MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125080227

License Status

CANCELLED

Business

Title

First Name

CHAD

Middle

RICHARD

Last Name

MARTENS

Business Name

CHAD RICHARD MARTENS MD

Original Issue Date

07/01/2022

Effective Date

07/01/2022

Expiration Date

06/30/2025

City

ROCKFORD

State

Zip

61104

County

WINNEBAGO

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

08/20/2025