MICHAEL CANNEY DEVISSER 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

Title

First Name

MICHAEL

Middle

CANNEY

Last Name

DEVISSER

Business Name

MICHAEL CANNEY DEVISSER MD

Original Issue Date

04/25/2019

Effective Date

05/07/2020

Expiration Date

07/31/2023

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023