DANIEL F CHAMBERLAIN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****51

License Status

NOT RENEWED

Business

First Name

DANIEL F

Last Name

CHAMBERLAIN

Suffix

Business Name

DANIEL F CHAMBERLAIN MD

Original Issue Date

10/25/1994

Effective Date

10/25/1994

Expiration Date

07/31/1996

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2011