JACK LEON DILTS Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****16

License Status

NOT RENEWED

Business

First Name

JACK LEON

Last Name

DILTS

Business Name

JACK LEON DILTS

Original Issue Date

01/01/1997

Expiration Date

09/01/1982

City

JACKSONVILLE

State

Zip

62650

County

MORGAN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006