ANNE MARIE KLOKOW MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****63

License Status

NOT RENEWED

Business

Title

First Name

ANNE

Middle

MARIE

Last Name

KLOKOW

Business Name

ANNE MARIE KLOKOW MD

Original Issue Date

07/21/2015

Effective Date

07/21/2015

Expiration Date

07/31/2017

City

ALTON

State

Zip

62002

County

MADISON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017