JOHN RICHARD WITTENBORN JR 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 RICHARD

Last Name

WITTENBORN JR

Suffix

Business Name

JOHN RICHARD WITTENBORN JR MD

Original Issue Date

09/16/1998

Effective Date

09/16/1998

Expiration Date

07/31/1999

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006