DANIEL JACK SKLANSKY MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****36

License Status

NOT RENEWED

Business

Title

First Name

DANIEL

Middle

JACK

Last Name

SKLANSKY

Business Name

DANIEL JACK SKLANSKY MD

Original Issue Date

06/25/2010

Effective Date

04/19/2011

Expiration Date

07/31/2014

City

ROCKFORD

State

Zip

61103

County

WINNEBAGO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014