PER KRISTIAN AMUNDSON 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

PER

Middle

KRISTIAN

Last Name

AMUNDSON

Suffix

Business Name

PER KRISTIAN AMUNDSON MD

Original Issue Date

11/19/2004

Effective Date

04/17/2008

Expiration Date

07/31/2011

City

MARION

State

Zip

62959

County

WILLIAMSON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/10/2011