DEAN J FONDAHN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****93

License Status

NOT RENEWED

Business

First Name

DEAN J

Last Name

FONDAHN

Suffix

Business Name

DEAN J FONDAHN MD

Original Issue Date

08/16/1983

Effective Date

06/07/2011

Expiration Date

07/31/2014

City

STERLING

State

Zip

61081

County

WHITESIDE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020