CHARLES PETER LATTUADA JR MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****05

License Status

CANCELLED

Business

First Name

CHARLES PETER

Last Name

LATTUADA JR

Suffix

Business Name

CHARLES PETER LATTUADA JR MD

Original Issue Date

07/17/1996

Effective Date

07/17/1996

Expiration Date

07/31/1999

City

SCOTT AFB

State

Zip

62225

County

SAINT CLAIR

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006