MARK STEPHEN LINGENFELTER 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

STEPHEN

Last Name

LINGENFELTER

Suffix

Business Name

MARK STEPHEN LINGENFELTER MD

Original Issue Date

10/14/2010

Effective Date

04/27/2017

Expiration Date

09/30/2020

City

ROCKFORD

State

Zip

61104

County

WINNEBAGO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021