BARRY IRWIN UNGERLEIDER DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****03

License Status

NOT RENEWED

Business

Title

First Name

BARRY

Middle

IRWIN

Last Name

UNGERLEIDER

Business Name

BARRY IRWIN UNGERLEIDER DO

Original Issue Date

07/14/2009

Effective Date

09/07/2011

Expiration Date

07/31/2014

City

ANNA

State

Zip

62906

County

UNION

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014