WILLARD J DAVIS DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****11

License Status

NOT RENEWED

Business

First Name

WILLARD

Middle

Last Name

DAVIS

Suffix

Business Name

WILLARD J DAVIS DO

Original Issue Date

01/19/2005

Effective Date

01/19/2005

Expiration Date

07/31/2008

City

CHICAGO

State

Zip

60612

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/06/2008