RYAN MICHAEL JOHNSON DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****08

License Status

ACTIVE

Business

Title

First Name

RYAN

Middle

MICHAEL

Last Name

JOHNSON

Business Name

RYAN MICHAEL JOHNSON DO

Original Issue Date

04/04/2023

Effective Date

04/04/2023

Expiration Date

07/31/2026

City

BLOOMINGTON

State

Zip

61704

County

MCLEAN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/04/2023