THOMAS P WENTLAND MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****68

License Status

NOT RENEWED

Business

Title

First Name

THOMAS

Middle

Last Name

WENTLAND

Business Name

THOMAS P WENTLAND MD

Original Issue Date

02/14/2002

Effective Date

02/14/2002

Expiration Date

07/31/2005

City

ROCKFORD

State

Zip

61109

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020