PETER THEODORE SCHLAKE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036062421

License Status

NOT RENEWED

Business

First Name

PETER THEODORE

Last Name

SCHLAKE

Suffix

Business Name

PETER THEODORE SCHLAKE MD

Original Issue Date

07/01/1981

Effective Date

04/17/2017

Expiration Date

09/30/2020

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

01/14/2021