THEDORE M PECK MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****20

License Status

NOT RENEWED

Business

First Name

THEDORE M

Last Name

PECK

Suffix

Business Name

THEDORE M PECK MD

Original Issue Date

01/01/1997

Expiration Date

01/01/1997

City

WOOD RIVER

State

Zip

62095

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006