JOHN FREDERIC GREEN MD 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

JOHN

Middle

FREDERIC

Last Name

GREEN

Suffix

Business Name

JOHN FREDERIC GREEN MD

Original Issue Date

01/01/1997

Effective Date

04/17/2008

Expiration Date

07/31/2011

City

MOLINE

State

Zip

61265

County

ROCK ISLAND

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/10/2011