WALTER R LILJESTHROM MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****06

License Status

NOT RENEWED

Business

First Name

WALTER R

Last Name

LILJESTHROM

Suffix

Business Name

WALTER R LILJESTHROM MD

Original Issue Date

01/01/1997

Expiration Date

01/01/1997

City

MARYVILLE

State

Zip

62062

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006