VAN EVANOFF JR 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

Title

First Name

VAN

Last Name

EVANOFF

Suffix

Business Name

VAN EVANOFF JR MD

Original Issue Date

05/16/2016

Effective Date

05/16/2016

Expiration Date

07/31/2017

City

ROBINSON

State

Zip

62454

County

CRAWFORD

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017