DAVID S FOOTERMAN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****54

License Status

NOT RENEWED

Business

First Name

DAVID S

Last Name

FOOTERMAN

Suffix

Business Name

DAVID S FOOTERMAN MD

Original Issue Date

08/08/1996

Effective Date

08/08/1996

Expiration Date

07/31/1999

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/12/2017