KATHLEEN JOHNSON 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

First Name

KATHLEEN

Last Name

JOHNSON

Suffix

Business Name

KATHLEEN JOHNSON MD

Original Issue Date

04/01/1983

Effective Date

05/09/2017

Expiration Date

09/30/2020

City

EDWARDS

State

Zip

61528

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021