JOHN M NIELSEN Podiatrist License verification

Business Entity

NOT RENEWED

License Type

Podiatrist

Description

LICENSED PODIATRY CONTROLLED SUBSTANCE

License Number

31*****04

License Status

NOT RENEWED

Business

First Name

JOHN M

Last Name

NIELSEN

Business Name

JOHN M NIELSEN

Original Issue Date

06/28/1991

Effective Date

01/07/2023

Expiration Date

01/31/2025

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/21/2026