LARRY W HOLDER MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****21

License Status

NOT RENEWED

Business

First Name

LARRY W

Last Name

HOLDER

Suffix

Business Name

LARRY W HOLDER MD

Original Issue Date

05/06/1988

Effective Date

09/11/2014

Expiration Date

07/31/2017

City

SPRINGFIELD

State

Zip

62702

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017