MATTHEW B JENSEN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****12

License Status

NOT RENEWED

Business

First Name

MATTHEW

Middle

Last Name

JENSEN

Suffix

Business Name

MATTHEW B JENSEN MD

Original Issue Date

02/16/2011

Effective Date

04/27/2017

Expiration Date

09/30/2020

City

ROCKFORD

State

Zip

61104

County

WISCONSIN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

01/14/2021