LELAND J FROM MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****10

License Status

NOT RENEWED

Business

First Name

LELAND J

Last Name

FROM

Suffix

Business Name

LELAND J FROM MD

Original Issue Date

08/31/1998

Effective Date

04/22/2011

Expiration Date

07/31/2014

City

ROSCOE

State

Zip

61073

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/12/2017