DAVID J CARLSON DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****10

License Status

NOT RENEWED

Business

Title

First Name

DAVID

Middle

Last Name

CARLSON

Business Name

DAVID J CARLSON DO

Original Issue Date

06/16/2014

Effective Date

06/16/2014

Expiration Date

07/31/2017

City

SPRINGFIELD

State

Zip

62711

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017