LAURETTA ANNE CONNELLY 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

LAURETTA ANNE

Last Name

CONNELLY

Business Name

LAURETTA ANNE CONNELLY

Original Issue Date

05/09/1996

Effective Date

05/09/1996

Expiration Date

07/31/1999

City

SILVIS

State

Zip

61282

County

ROCK ISLAND

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006