JEAN A DISSELER MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****89

License Status

NOT RENEWED

Business

First Name

JEAN A

Last Name

DISSELER

Suffix

Business Name

JEAN A DISSELER MD

Original Issue Date

12/11/1990

Effective Date

05/28/2020

Expiration Date

07/31/2023

City

QUINCY

State

Zip

62301

County

ADAMS

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023