NIELS C ANDERSEN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****90

License Status

NOT RENEWED

Business

First Name

NIELS C

Last Name

ANDERSEN

Suffix

Business Name

NIELS C ANDERSEN MD

Original Issue Date

01/13/1984

Effective Date

01/13/1984

Expiration Date

07/31/1987

City

PEORIA

State

Zip

61637

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006