DANIEL P CONGREVE MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****73

License Status

CANCELLED

Business

First Name

DANIEL P

Last Name

CONGREVE

Suffix

Business Name

DANIEL P CONGREVE MD

Original Issue Date

03/11/1996

Effective Date

03/11/1996

Expiration Date

07/31/2002

City

ROCK ISLAND

State

Zip

61201

County

ROCK ISLAND

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020