MICHAEL D MEDLOCK Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****04

License Status

NOT RENEWED

Business

First Name

MICHAEL D

Last Name

MEDLOCK

Business Name

MICHAEL D MEDLOCK

Original Issue Date

10/23/1989

Effective Date

10/23/1989

Expiration Date

07/31/1996

City

PEORIA

State

Zip

61637

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006