CHRISTOPHER SCOTT ENNEN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****40

License Status

NOT RENEWED

Business

Title

First Name

CHRISTOPHER

Middle

SCOTT

Last Name

ENNEN

Business Name

CHRISTOPHER SCOTT ENNEN MD

Original Issue Date

02/03/2012

Effective Date

04/08/2014

Expiration Date

07/31/2017

City

ROCKFORD

State

Zip

61103

County

WINNEBAGO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017