DANIEL RYAN LAURSEN DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****32

License Status

NOT RENEWED

Business

Title

First Name

DANIEL

Middle

RYAN

Last Name

LAURSEN

Business Name

DANIEL RYAN LAURSEN DO

Original Issue Date

12/23/2019

Effective Date

12/23/2019

Expiration Date

09/30/2020

City

PEORIA

State

Zip

61615

County

PEORIA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021