JOHN CHARLES FREDERICK MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****78

License Status

NOT RENEWED

Business

First Name

JOHN

Middle

CHARLES

Last Name

FREDERICK

Suffix

Business Name

JOHN CHARLES FREDERICK MD

Original Issue Date

05/09/2006

Effective Date

05/08/2017

Expiration Date

09/30/2020

City

SILVIS

State

Zip

61282

County

ROCK ISLAND

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021