DAVID ALLEN ANDERSEN 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

First Name

DAVID ALLEN

Last Name

ANDERSEN

Suffix

Business Name

DAVID ALLEN ANDERSEN MD

Original Issue Date

07/14/2008

Effective Date

07/14/2008

Expiration Date

07/31/2011

City

ALTON

State

Zip

62002

County

MADISON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/10/2011