MARK CUNDIFF JOHNSON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****56

License Status

NOT RENEWED

Business

First Name

MARK

Middle

CUNDIFF

Last Name

JOHNSON

Suffix

Business Name

MARK CUNDIFF JOHNSON MD

Original Issue Date

11/17/1997

Effective Date

11/17/1997

Expiration Date

07/31/1999

City

GRANITE CITY

State

Zip

62040

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006