JOHN EDWARD KALLICH MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****97

License Status

CANCELLED

Business

First Name

JOHN EDWARD

Last Name

KALLICH

Suffix

Business Name

JOHN EDWARD KALLICH MD

Original Issue Date

05/26/2000

Effective Date

05/26/2000

Expiration Date

07/31/2008

City

ROCKFORD

State

Zip

61111

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/17/2008