DEXTER EMERSON HAZLEWOOD MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****01

License Status

NOT RENEWED

Business

First Name

DEXTER

Middle

EMERSON

Last Name

HAZLEWOOD

Suffix

Business Name

DEXTER EMERSON HAZLEWOOD MD

Original Issue Date

10/22/2002

Effective Date

10/22/2002

Expiration Date

07/31/2008

City

PEORIA

State

Zip

61614

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020