DANIEL ANTHONY LIESEN MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****26

License Status

ACTIVE

Business

First Name

DANIEL

Middle

ANTHONY

Last Name

LIESEN

Suffix

Business Name

DANIEL ANTHONY LIESEN MD

Original Issue Date

06/27/2006

Effective Date

07/21/2023

Expiration Date

07/31/2026

City

GURNEE

State

Zip

60031

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/21/2023