JOHN A MASSIMILIAN DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****96

License Status

NOT RENEWED

Business

First Name

JOHN A

Last Name

MASSIMILIAN

Suffix

Business Name

JOHN A MASSIMILIAN DO

Original Issue Date

06/08/2017

Effective Date

06/08/2017

Expiration Date

09/30/2020

City

ALEDO

State

Zip

61231

County

MERCER

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021