DUSTIN KEITH JOHNSON MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****28

License Status

CANCELLED

Business

Title

First Name

DUSTIN

Middle

KEITH

Last Name

JOHNSON

Business Name

DUSTIN KEITH JOHNSON MD

Original Issue Date

12/10/2013

Effective Date

12/10/2013

Expiration Date

07/31/2014

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/08/2014