LYNNE SUSAN POWELL MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****57

License Status

NOT RENEWED

Business

Title

First Name

LYNNE

Middle

SUSAN

Last Name

POWELL

Business Name

LYNNE SUSAN POWELL MD

Original Issue Date

02/20/2014

Effective Date

05/18/2020

Expiration Date

07/31/2023

City

ROCKFORD

State

Zip

61103

County

WINNEBAGO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023