THOR AGUSTSSON DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****17

License Status

NOT RENEWED

Business

Title

First Name

THOR

Last Name

AGUSTSSON

Business Name

THOR AGUSTSSON DO

Original Issue Date

06/06/2012

Effective Date

06/06/2012

Expiration Date

07/31/2014

City

NAPERVILLE

State

Zip

60540

County

DUPAGE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014