CARL W SODERSTROM MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****81

License Status

ACTIVE

Business

First Name

CARL W

Last Name

SODERSTROM

Suffix

Business Name

CARL W SODERSTROM MD

Original Issue Date

01/01/1997

Effective Date

06/23/2023

Expiration Date

07/31/2026

City

PEORIA

State

Zip

61614

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/23/2023