GEOFFREY SCOTT VAN THIEL MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****64

License Status

NOT RENEWED

Business

First Name

GEOFFREY

Middle

SCOTT

Last Name

VAN THIEL

Suffix

Business Name

GEOFFREY SCOTT VAN THIEL MD

Original Issue Date

11/01/2013

Effective Date

06/18/2020

Expiration Date

07/31/2023

City

ROCKFORD

State

Zip

61101

County

WINNEBAGO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023