DANIEL P CONGREVE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****72

License Status

NOT RENEWED

Business

First Name

DANIEL P

Last Name

CONGREVE

Suffix

Business Name

DANIEL P CONGREVE MD

Original Issue Date

01/01/1997

Effective Date

07/11/2017

Expiration Date

09/30/2020

City

DAHINDA

State

Zip

61428

County

HENRY

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021