HOWARD E WIARDA Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****91

License Status

ACTIVE

Business

First Name

HOWARD E

Last Name

WIARDA

Business Name

HOWARD E WIARDA

Original Issue Date

05/21/2007

Effective Date

04/10/2023

Expiration Date

07/31/2026

City

GRANGER

State

Zip

46530

County

MACON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/10/2023