THEODORE DAVID CONLIFFE JR 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

THEODORE

Middle

DAVID

Last Name

CONLIFFE

Suffix

JR MD

Business Name

THEODORE DAVID CONLIFFE JR MD

Original Issue Date

12/23/1997

Effective Date

12/23/1997

Expiration Date

07/31/1999

City

MONMOUTH

State

Zip

61462

County

WARREN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006