MARK R JOHNSON MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****22

License Status

ACTIVE

Business

First Name

MARK R

Last Name

JOHNSON

Suffix

Business Name

MARK R JOHNSON MD

Original Issue Date

07/25/1996

Effective Date

06/27/2023

Expiration Date

07/31/2026

City

SPRINGFIELD

State

Zip

62702

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/27/2023