NINAH PAULINE CLEGG-JOHNSON DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****00

License Status

ACTIVE

Business

Title

First Name

NINAH

Middle

PAULINE

Last Name

CLEGG-JOHNSON

Business Name

NINAH PAULINE CLEGG-JOHNSON DO

Original Issue Date

01/04/2021

Effective Date

05/16/2023

Expiration Date

07/31/2026

City

PEORIA

State

Zip

61605

County

PEORIA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/16/2023