DIRK R DEHAAS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****69

License Status

NOT RENEWED

Business

First Name

DIRK

Middle

Last Name

DEHAAS

Suffix

Business Name

DIRK R DEHAAS MD

Original Issue Date

02/24/2005

Effective Date

05/08/2014

Expiration Date

07/31/2017

City

SILVIS

State

Zip

61282

County

ROCK ISLAND

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020