AI-XUAN L HOLTERMAN Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****49

License Status

NOT RENEWED

Business

First Name

AI-XUAN L

Last Name

HOLTERMAN

Business Name

AI-XUAN L HOLTERMAN

Original Issue Date

06/16/1997

Effective Date

09/03/2020

Expiration Date

07/31/2023

City

WARRENVILLE

State

Zip

60555

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023