KEITH H SWENSON MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****85

License Status

CANCELLED

Business

First Name

KEITH H

Last Name

SWENSON

Suffix

Business Name

KEITH H SWENSON MD

Original Issue Date

01/01/1997

Expiration Date

09/01/1982

City

ROCKFORD

State

Zip

61101

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006