LISA M PHILLIPS MD 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

LISA M

Last Name

PHILLIPS

Suffix

Business Name

LISA M PHILLIPS MD

Original Issue Date

11/16/1983

Effective Date

07/28/2020

Expiration Date

07/31/2023

City

PEORIA

State

Zip

61603

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023