LARRY L WELLENDORF II Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****38

License Status

NOT RENEWED

Business

First Name

LARRY L

Last Name

WELLENDORF II

Business Name

LARRY L WELLENDORF II

Original Issue Date

08/24/2018

Effective Date

05/29/2020

Expiration Date

07/31/2023

City

ROCKFORD

State

Zip

61114

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023