JASON HENRY KOENIG BELL MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****00

License Status

NOT RENEWED

Business

Title

First Name

JASON

Middle

HENRY KOENIG

Last Name

BELL

Business Name

JASON HENRY KOENIG BELL MD

Original Issue Date

06/30/2016

Effective Date

06/30/2016

Expiration Date

07/31/2017

City

ROCKFORD

State

Zip

61103

County

WINNEBAGO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017