TRENT D PROEHL Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****54

License Status

ACTIVE

Business

First Name

TRENT

Middle

Last Name

PROEHL

Business Name

TRENT D PROEHL

Original Issue Date

05/25/2004

Effective Date

07/27/2023

Expiration Date

07/31/2026

City

TREMONT

State

Zip

61568

County

LIVINGSTON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/27/2023