JUSTIN LEE THELEMAN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036158448

License Status

NOT RENEWED

Business

Title

First Name

JUSTIN

Middle

LEE

Last Name

THELEMAN

Business Name

JUSTIN LEE THELEMAN MD

Original Issue Date

10/06/2021

Effective Date

10/06/2021

Expiration Date

07/31/2023

City

PEORIA

State

Zip

61605

County

PEORIA

Ever Disciplined

LastModifiedDate

11/30/2023