J EDGAR ALLEN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****77

License Status

NOT RENEWED

Business

First Name

J EDGAR

Last Name

ALLEN

Suffix

Business Name

J EDGAR ALLEN MD

Original Issue Date

12/27/1989

Effective Date

12/27/1989

Expiration Date

07/31/1990

City

ROCKFORD

State

Zip

61102

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2011