DOUGLAS W EDGREN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****73

License Status

NOT RENEWED

Business

First Name

DOUGLAS

Middle

Last Name

EDGREN

Suffix

Business Name

DOUGLAS W EDGREN MD

Original Issue Date

07/25/1995

Effective Date

06/05/2014

Expiration Date

07/31/2017

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017