LISA RENE JOHNSON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****67

License Status

NOT RENEWED

Business

First Name

LISA

Middle

RENE

Last Name

JOHNSON

Suffix

Business Name

LISA RENE JOHNSON MD

Original Issue Date

08/25/2003

Effective Date

08/25/2003

Expiration Date

07/31/2005

City

MOLINE

State

Zip

61265

County

ROCK ISLAND

Controlled Substance Schedule

II III IV

Ever Disciplined

LastModifiedDate

10/09/2006