UTE C PROHASKA Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****08

License Status

NOT RENEWED

Business

First Name

UTE C

Last Name

PROHASKA

Business Name

UTE C PROHASKA

Original Issue Date

08/23/1991

Effective Date

05/04/2017

Expiration Date

09/30/2020

City

PEORIA

State

Zip

61614

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021