PATRICIA A VANDER LAAN 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

First Name

PATRICIA A

Last Name

VANDER LAAN

Suffix

Business Name

PATRICIA A VANDER LAAN MD

Original Issue Date

08/10/1983

Effective Date

08/10/1983

Expiration Date

07/31/1987

City

ROCKFORD

State

Zip

61101

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006