TIMOTHY W OLSEN 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

TIMOTHY W

Last Name

OLSEN

Business Name

TIMOTHY W OLSEN

Original Issue Date

07/24/1996

Effective Date

07/24/1996

Expiration Date

07/31/1999

City

ROCKFORD

State

Zip

61107

County

BOONE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006