DAVID LEE MATLOCK Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036121442

License Status

NOT RENEWED

Business

First Name

DAVID

Middle

LEE

Last Name

MATLOCK

Business Name

DAVID LEE MATLOCK

Original Issue Date

07/09/2008

Effective Date

06/06/2011

Expiration Date

07/31/2014

City

DUNLAP

State

Zip

61525

County

PEORIA

Ever Disciplined

LastModifiedDate

11/17/2014