JANICE DIANE MCDANIEL MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****62

License Status

NOT RENEWED

Business

Title

First Name

JANICE

Middle

DIANE

Last Name

MCDANIEL

Business Name

JANICE DIANE MCDANIEL MD

Original Issue Date

02/27/2019

Effective Date

02/27/2019

Expiration Date

09/30/2020

City

ROCKFORD

State

Zip

61103

County

WINNEBAGO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021