MARLA RAE ANDERSON 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

Title

First Name

MARLA

Middle

RAE

Last Name

ANDERSON

Business Name

MARLA RAE ANDERSON MD

Original Issue Date

07/26/2016

Effective Date

06/12/2017

Expiration Date

09/30/2020

City

PEORIA

State

Zip

61606

County

PEORIA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021