JOHN CARL DANNENFELDT MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****28

License Status

NOT RENEWED

Business

First Name

JOHN CARL

Last Name

DANNENFELDT

Suffix

Business Name

JOHN CARL DANNENFELDT MD

Original Issue Date

05/19/1989

Effective Date

05/19/1989

Expiration Date

07/31/1996

City

ORION

State

Zip

61273

County

HENRY

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020