CARLEEN MARIE FREESMEIER Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****42

License Status

NOT RENEWED

Business

First Name

CARLEEN

Middle

MARIE

Last Name

FREESMEIER

Business Name

CARLEEN MARIE FREESMEIER

Original Issue Date

08/03/2005

Effective Date

02/27/2020

Expiration Date

03/01/2022

City

ROCKFORD

State

Zip

61104

County

WINNEBAGO

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/27/2022