RICHARD P PUCKETT MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****09

License Status

NOT RENEWED

Business

First Name

RICHARD P

Last Name

PUCKETT

Suffix

Business Name

RICHARD P PUCKETT MD

Original Issue Date

01/01/1997

Effective Date

05/21/2008

Expiration Date

07/31/2011

City

BLOOMINGTON

State

Zip

61704

County

MCLEAN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/10/2011