MICHAEL K OUWENGA 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

MICHAEL

Middle

Last Name

OUWENGA

Business Name

MICHAEL K OUWENGA

Original Issue Date

12/17/2003

Effective Date

04/26/2017

Expiration Date

09/30/2020

City

QUINCY

State

Zip

62301

County

ADAMS

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021