ROGER KERMIT JOHNSON 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

First Name

ROGER KERMIT

Last Name

JOHNSON

Suffix

Business Name

ROGER KERMIT JOHNSON MD

Original Issue Date

01/01/1997

Effective Date

04/17/2008

Expiration Date

07/31/2011

City

ROCKFORD

State

Zip

61114

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/10/2011