FREDERICK DANIEL LANDIS III MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****19

License Status

NOT RENEWED

Business

First Name

FREDERICK DANIEL

Last Name

LANDIS III

Suffix

Business Name

FREDERICK DANIEL LANDIS III MD

Original Issue Date

01/01/1997

Expiration Date

09/01/1982

City

PEORIA

State

Zip

61603

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006