JAN MARIE LARSON 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

JAN MARIE

Last Name

LARSON

Business Name

JAN MARIE LARSON

Original Issue Date

03/31/1986

Effective Date

03/31/1986

Expiration Date

07/31/1993

City

MOLINE

State

Zip

61265

County

ROCK ISLAND

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006