MARK C JOHNSON 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

First Name

MARK C

Last Name

JOHNSON

Suffix

Business Name

MARK C JOHNSON MD

Original Issue Date

01/18/2005

Effective Date

01/18/2005

Expiration Date

07/31/2008

City

QUINCY

State

Zip

62301

County

ADAMS

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020