JOSEPH DANA VERZWYVELT MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****80

License Status

NOT RENEWED

Business

Title

First Name

JOSEPH

Middle

DANA

Last Name

VERZWYVELT

Business Name

JOSEPH DANA VERZWYVELT MD

Original Issue Date

09/11/2015

Effective Date

09/11/2015

Expiration Date

07/31/2017

City

ROCKFORD

State

Zip

61101

County

WINNEBAGO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020