JORDAN EVAN BRAND MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****52

License Status

NOT RENEWED

Business

Title

First Name

JORDAN

Middle

EVAN

Last Name

BRAND

Business Name

JORDAN EVAN BRAND MD

Original Issue Date

07/31/2012

Effective Date

07/31/2012

Expiration Date

07/31/2014

City

ROCKFORD

State

Zip

61103

County

WINNEBAGO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014