ANN AGUSTSSON-MATHERS Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****42

License Status

NOT RENEWED

Business

First Name

ANN

Last Name

AGUSTSSON-MATHERS

Business Name

ANN AGUSTSSON-MATHERS

Original Issue Date

01/01/1997

Effective Date

09/18/2017

Expiration Date

09/30/2020

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021