JODY PATRICK JOHNSEN DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****09

License Status

NOT RENEWED

Business

First Name

JODY

Middle

PATRICK

Last Name

JOHNSEN

Suffix

Business Name

JODY PATRICK JOHNSEN DO

Original Issue Date

10/06/2003

Effective Date

10/06/2003

Expiration Date

07/31/2008

City

ELMHURST

State

Zip

60126

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2011