ROBERT BLAKE HEGEMAN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****98

License Status

NOT RENEWED

Business

Title

First Name

ROBERT

Middle

BLAKE

Last Name

HEGEMAN

Business Name

ROBERT BLAKE HEGEMAN MD

Original Issue Date

04/05/2012

Effective Date

04/05/2012

Expiration Date

07/31/2014

City

MADISON

State

Zip

53715

County

WISCONSIN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014