NEIL WALTER JORGENSEN 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

NEIL WALTER

Last Name

JORGENSEN

Suffix

Business Name

NEIL WALTER JORGENSEN MD

Original Issue Date

04/05/1994

Effective Date

04/05/1994

Expiration Date

07/31/1996

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

09/26/2006