DENNIS OWEN BACKSTROM MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****41

License Status

ACTIVE

Business

First Name

DENNIS OWEN

Last Name

BACKSTROM

Suffix

Business Name

DENNIS OWEN BACKSTROM MD

Original Issue Date

01/01/1997

Effective Date

04/17/2023

Expiration Date

07/31/2026

City

JACKSONVILLE

State

Zip

62650

County

MORGAN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/17/2023