THOMAS M JOHNSON MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****22

License Status

CANCELLED

Business

First Name

THOMAS M

Last Name

JOHNSON

Suffix

Business Name

THOMAS M JOHNSON MD

Original Issue Date

06/20/1988

Effective Date

06/20/1988

Expiration Date

07/31/2005

City

GALENA

State

Zip

61036

County

JO DAVIESS

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006