JOHN FREDERIC GREEN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****45

License Status

NOT RENEWED

Business

First Name

JOHN

Middle

FREDERIC

Last Name

GREEN

Suffix

Business Name

JOHN FREDERIC GREEN MD

Original Issue Date

07/20/1982

Effective Date

07/20/1982

Expiration Date

07/31/1996

City

MILAN

State

Zip

61264

County

ROCK ISLAND

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2011