PHILIP CARLSON-DEXTER MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****57

License Status

ACTIVE

Business

Title

First Name

PHILIP

Last Name

CARLSON-DEXTER

Business Name

PHILIP CARLSON-DEXTER MD

Original Issue Date

02/10/2020

Effective Date

06/17/2023

Expiration Date

07/31/2026

City

ROCKFORD

State

Zip

61103

County

WINNEBAGO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/17/2023