MARK LEROY LUNDINE MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****33

License Status

ACTIVE

Business

First Name

MARK LEROY

Last Name

LUNDINE

Suffix

Business Name

MARK LEROY LUNDINE MD

Original Issue Date

01/01/1997

Effective Date

04/08/2023

Expiration Date

07/31/2026

City

ROCKFORD

State

Zip

61108

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/08/2023