HUIBERT MICHIEL VRIESENDORP MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****88

License Status

NOT RENEWED

Business

First Name

HUIBERT

Middle

MICHIEL

Last Name

VRIESENDORP

Suffix

Business Name

HUIBERT MICHIEL VRIESENDORP MD

Original Issue Date

12/20/2007

Effective Date

12/20/2007

Expiration Date

07/31/2008

City

CHAMPAIGN

State

Zip

61820

County

CHAMPAIGN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/06/2008