RALPH WILLIAM THEOBALD 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

First Name

RALPH WILLIAM

Last Name

THEOBALD

Suffix

Business Name

RALPH WILLIAM THEOBALD MD

Original Issue Date

01/01/1997

Expiration Date

07/31/1990

City

QUINCY

State

Zip

62301

County

ADAMS

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006