DAVID ROBERT DEHAAN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****05

License Status

NOT RENEWED

Business

First Name

DAVID

Middle

ROBERT

Last Name

DEHAAN

Suffix

Business Name

DAVID ROBERT DEHAAN MD

Original Issue Date

10/28/2010

Effective Date

04/05/2011

Expiration Date

07/31/2014

City

LOMBARD

State

Zip

60148

County

DUPAGE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020