BILUE ANNIE THOMAS MD 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

First Name

BILUE

Middle

ANNIE

Last Name

THOMAS

Suffix

Business Name

BILUE ANNIE THOMAS MD

Original Issue Date

08/06/2008

Effective Date

08/06/2008

Expiration Date

07/31/2011

City

CHAMPAIGN

State

Zip

61820

County

CHAMPAIGN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/10/2011