MICHAEL JOHN WALDEN DO 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

Title

First Name

MICHAEL

Middle

JOHN

Last Name

WALDEN

Business Name

MICHAEL JOHN WALDEN DO

Original Issue Date

08/11/2015

Effective Date

05/08/2017

Expiration Date

09/30/2020

City

SPRINGFIELD

State

Zip

62704

County

SANGAMON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021