DANE JOHNSON MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****11

License Status

ACTIVE

Business

Title

First Name

DANE

Last Name

JOHNSON

Business Name

DANE JOHNSON MD

Original Issue Date

08/07/2019

Effective Date

06/16/2023

Expiration Date

07/31/2026

City

ST LOUIS

State

Zip

63110

County

MADISON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/16/2023