MARK H GOERGEN 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

First Name

MARK H

Last Name

GOERGEN

Suffix

Business Name

MARK H GOERGEN MD

Original Issue Date

01/07/1985

Effective Date

06/15/2020

Expiration Date

07/31/2023

City

EAST PEORIA

State

Zip

61614

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023