CAMILLA JUNE FREDERICK MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****05

License Status

ACTIVE

Business

First Name

CAMILLA JUNE

Last Name

FREDERICK

Suffix

Business Name

CAMILLA JUNE FREDERICK MD

Original Issue Date

08/18/1992

Effective Date

07/07/2023

Expiration Date

07/31/2026

City

MOLINE

State

Zip

61265

County

ROCK ISLAND

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/07/2023