DANIEL HENRY VON DER VELLEN MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125084244

License Status

ACTIVE

Business

Title

First Name

DANIEL

Middle

HENRY

Last Name

VON DER VELLEN

Business Name

DANIEL HENRY VON DER VELLEN MD

Original Issue Date

07/01/2024

Effective Date

07/01/2024

Expiration Date

06/30/2027

City

PEORIA

State

Zip

61605

Specialty/Qualifier

Internal Medicine/Pediatrics

Ever Disciplined

LastModifiedDate

06/06/2024