DAVID P VAN DAM MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****75

License Status

NOT RENEWED

Business

First Name

DAVID

Middle

Last Name

VAN DAM

Suffix

Business Name

DAVID P VAN DAM MD

Original Issue Date

01/01/1997

Expiration Date

07/31/2005

City

CRYSTAL LAKE

State

Zip

60014

County

MCHENRY

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020