JOSEPH DANA VERZWYVELT 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

Title

First Name

JOSEPH

Middle

DANA

Last Name

VERZWYVELT

Business Name

JOSEPH DANA VERZWYVELT MD

Original Issue Date

04/29/2015

Effective Date

04/11/2017

Expiration Date

09/30/2020

City

ROCKFORD

State

Zip

61103

County

WINNEBAGO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021