DAVID ALFRED RODENBERG MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****17

License Status

INACTIVE

Business

First Name

DAVID

Middle

ALFRED

Last Name

RODENBERG

Suffix

Business Name

DAVID ALFRED RODENBERG MD

Original Issue Date

01/01/1997

Effective Date

07/11/2023

Expiration Date

07/31/2026

City

PEORIA

State

Zip

61614

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/11/2023