MICHAEL R JOHNSON 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

MICHAEL R

Last Name

JOHNSON

Suffix

Business Name

MICHAEL R JOHNSON MD

Original Issue Date

05/19/2003

Effective Date

05/19/2003

Expiration Date

07/31/2008

City

WASHINGTON

State

Zip

61571

County

TAZEWELL

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020