DARRELL D RUST MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****12

License Status

NOT RENEWED

Business

First Name

DARRELL D

Last Name

RUST

Suffix

Business Name

DARRELL D RUST MD

Original Issue Date

08/14/1984

Effective Date

08/14/1984

Expiration Date

07/31/1993

City

PEORIA

State

Zip

61637

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020