JUSTIN KURT LIEGMANN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****85

License Status

NOT RENEWED

Business

Title

First Name

JUSTIN

Middle

KURT

Last Name

LIEGMANN

Business Name

JUSTIN KURT LIEGMANN MD

Original Issue Date

04/04/2022

Effective Date

04/04/2022

Expiration Date

07/31/2023

City

PEORIA

State

Zip

61604

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023