NICOLAAS MICHAEL JONGERIUS MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****75

License Status

ACTIVE

Business

First Name

NICOLAAS MICHAEL

Last Name

JONGERIUS

Suffix

Business Name

NICOLAAS MICHAEL JONGERIUS MD

Original Issue Date

07/25/1984

Effective Date

04/20/2023

Expiration Date

07/31/2026

City

PEORIA

State

Zip

61616

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/20/2023