LAUREL G PORTER Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****15

License Status

NOT RENEWED

Business

First Name

LAUREL G

Last Name

PORTER

Business Name

LAUREL G PORTER

Original Issue Date

01/17/1996

Effective Date

01/17/1996

Expiration Date

07/31/1996

City

GALESBURG

State

Zip

61401

County

KNOX

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006