CONNIE D ANDERSON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****58

License Status

NOT RENEWED

Business

Title

First Name

CONNIE

Middle

Last Name

ANDERSON

Business Name

CONNIE D ANDERSON MD

Original Issue Date

06/25/2021

Effective Date

06/25/2021

Expiration Date

07/31/2023

City

EDWARDSVILLE

State

Zip

62025

County

MADISON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023