LEON A POVEDA Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****00

License Status

CANCELLED

Business

First Name

LEON

Middle

Last Name

POVEDA

Business Name

LEON A POVEDA

Original Issue Date

09/21/1999

Effective Date

09/21/1999

Expiration Date

07/31/2005

City

EAST PEORIA

State

Zip

61611

County

TAZEWELL

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006