DANIEL R JIMENEZ MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****55

License Status

NOT RENEWED

Business

First Name

DANIEL R

Last Name

JIMENEZ

Suffix

Business Name

DANIEL R JIMENEZ MD

Original Issue Date

10/08/1982

Effective Date

10/08/1982

Expiration Date

07/31/2002

City

ROCKFORD

State

Zip

61111

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006