SUSAN FEDER MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****26

License Status

NOT RENEWED

Business

First Name

SUSAN

Last Name

FEDER

Suffix

Business Name

SUSAN FEDER MD

Original Issue Date

05/09/1984

Effective Date

07/19/2012

Expiration Date

07/31/2014

City

ROCKFORD

State

Zip

61114

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020