DAVID S FOOTERMAN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****53

License Status

NOT RENEWED

Business

First Name

DAVID S

Last Name

FOOTERMAN

Suffix

Business Name

DAVID S FOOTERMAN MD

Original Issue Date

01/15/1992

Effective Date

08/28/2017

Expiration Date

09/30/2020

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021