JON DIRK VAN ROO MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****45

License Status

NOT RENEWED

Business

First Name

JON

Middle

DIRK

Last Name

VAN ROO

Suffix

Business Name

JON DIRK VAN ROO MD

Original Issue Date

03/26/2009

Effective Date

05/29/2014

Expiration Date

07/31/2017

City

HARTLAND

State

Zip

53029

County

WISCONSIN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV

Ever Disciplined

LastModifiedDate

11/01/2017