WADE D CARLSON Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****03

License Status

ACTIVE

Business

First Name

WADE

Middle

Last Name

CARLSON

Business Name

WADE D CARLSON

Original Issue Date

04/12/2004

Effective Date

04/18/2023

Expiration Date

07/31/2026

City

PEORIA

State

Zip

61615

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/18/2023