DANIEL F CHAMBERLAIN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****50

License Status

NOT RENEWED

Business

First Name

DANIEL F

Last Name

CHAMBERLAIN

Suffix

Business Name

DANIEL F CHAMBERLAIN MD

Original Issue Date

05/20/1992

Effective Date

06/23/2008

Expiration Date

07/31/2011

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/10/2011