THERESA W RUDDY MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****18

License Status

NOT RENEWED

Business

First Name

THERESA

Middle

Last Name

RUDDY

Suffix

Business Name

THERESA W RUDDY MD

Original Issue Date

08/03/2007

Effective Date

08/03/2007

Expiration Date

07/31/2008

City

FREEPORT

State

Zip

61032

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/06/2008