DANIEL ROBERT ANDERSON 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

DANIEL

Middle

ROBERT

Last Name

ANDERSON

Business Name

DANIEL ROBERT ANDERSON MD

Original Issue Date

07/12/2017

Effective Date

07/12/2017

Expiration Date

09/30/2020

City

SPRINGFIELD

State

Zip

62769

County

SANGAMON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021