DREW R VAN KERREBROECK 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

DREW

Middle

Last Name

VAN KERREBROECK

Business Name

DREW R VAN KERREBROECK

Original Issue Date

07/14/2003

Effective Date

06/14/2017

Expiration Date

09/30/2020

City

CAMBRIDGE

State

Zip

61238

County

HENRY

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021