MARYL R JOHNSON MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****89

License Status

ACTIVE

Business

First Name

MARYL

Middle

Last Name

JOHNSON

Suffix

Business Name

MARYL R JOHNSON MD

Original Issue Date

08/29/1988

Effective Date

04/07/2023

Expiration Date

07/31/2026

City

ROCKFORD

State

Zip

61104

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2023