JOHN FREDERIC GREEN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****46

License Status

NOT RENEWED

Business

First Name

JOHN

Middle

FREDERIC

Last Name

GREEN

Suffix

Business Name

JOHN FREDERIC GREEN MD

Original Issue Date

12/20/1989

Effective Date

12/20/1989

Expiration Date

07/31/1990

City

EAST MOLINE

State

Zip

61244

County

ROCK ISLAND

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2011