DANIEL GORDON HAFENRICHTER MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****72

License Status

ACTIVE

Business

First Name

DANIEL

Middle

GORDON

Last Name

HAFENRICHTER

Suffix

Business Name

DANIEL GORDON HAFENRICHTER MD

Original Issue Date

10/12/2004

Effective Date

07/26/2023

Expiration Date

07/31/2026

City

WATERLOO

State

Zip

62298

County

MONROE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/26/2023