HENRY DENNIS MOLLMAN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****76

License Status

NOT RENEWED

Business

Title

First Name

HENRY

Middle

DENNIS

Last Name

MOLLMAN

Business Name

HENRY DENNIS MOLLMAN MD

Original Issue Date

08/12/2008

Effective Date

08/12/2008

Expiration Date

07/31/2011

City

SPRINGFIELD

State

Zip

62794

County

SANGAMON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV

Ever Disciplined

LastModifiedDate

11/10/2011