SUSAN FEDER 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

SUSAN

Last Name

FEDER

Suffix

Business Name

SUSAN FEDER MD

Original Issue Date

10/02/2012

Effective Date

10/02/2012

Expiration Date

07/31/2014

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020