LEO THAI MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****06

License Status

NOT RENEWED

Business

Title

First Name

LEO

Last Name

THAI

Business Name

LEO THAI MD

Original Issue Date

07/15/2016

Effective Date

07/27/2017

Expiration Date

09/30/2020

City

CHAMPAIGN

State

Zip

61820

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

01/14/2021