DANIEL L BOMMELJE DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****51

License Status

ACTIVE

Business

First Name

DANIEL L

Last Name

BOMMELJE

Suffix

Business Name

DANIEL L BOMMELJE DO

Original Issue Date

07/17/1996

Effective Date

04/21/2023

Expiration Date

07/31/2026

City

MATTOON

State

Zip

61938

County

COLES

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/21/2023