CLARENCE DAVID ENGSTROM MD Medical Doctor License verification

Business Entity

INOPERATIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****23

License Status

INOPERATIVE

Business

First Name

CLARENCE DAVID

Last Name

ENGSTROM

Suffix

Business Name

CLARENCE DAVID ENGSTROM MD

Original Issue Date

01/01/1997

Effective Date

08/12/2023

Expiration Date

07/31/2026

City

ZION

State

Zip

60099

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/12/2023