CHAD MICHAEL RONHOLM MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****94

License Status

NOT RENEWED

Business

Title

First Name

CHAD

Middle

MICHAEL

Last Name

RONHOLM

Business Name

CHAD MICHAEL RONHOLM MD

Original Issue Date

09/21/2012

Effective Date

09/21/2012

Expiration Date

07/31/2014

City

CARLINVILLE

State

Zip

62626

County

MACOUPIN

Specialty/Qualifier

PRACTITIONER

Ever Disciplined

LastModifiedDate

04/05/2020