DOUGLAS MARK JOHNSON DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****97

License Status

NOT RENEWED

Business

Title

First Name

DOUGLAS

Middle

MARK

Last Name

JOHNSON

Business Name

DOUGLAS MARK JOHNSON DO

Original Issue Date

02/27/2014

Effective Date

07/21/2014

Expiration Date

07/31/2017

City

NAPERVILLE

State

Zip

60565

County

DUPAGE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV

Ever Disciplined

LastModifiedDate

11/01/2017