ROBERT J DORMAN JR DO 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

ROBERT J

Last Name

DORMAN JR

Suffix

Business Name

ROBERT J DORMAN JR DO

Original Issue Date

12/07/1983

Effective Date

06/22/2017

Expiration Date

09/30/2020

City

ROCK FALLS

State

Zip

61071

County

WHITESIDE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021