ALBERT H BONNEMA JR MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****18

License Status

CANCELLED

Business

First Name

ALBERT

Middle

Last Name

BONNEMA

Suffix

JR MD

Business Name

ALBERT H BONNEMA JR MD

Original Issue Date

12/06/2000

Effective Date

12/06/2000

Expiration Date

07/31/2005

City

SCOTT AFB

State

Zip

62225

County

SAINT CLAIR

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006