SHARON K DYKSTRA Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****17

License Status

CANCELLED

Business

First Name

SHARON K

Last Name

DYKSTRA

Business Name

SHARON K DYKSTRA

Original Issue Date

12/03/1998

Effective Date

12/03/1998

Expiration Date

07/31/2005

City

ROCK ISLAND

State

Zip

61201

County

ROCK ISLAND

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006