DAVID LEE COLGROVE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****25

License Status

NOT RENEWED

Business

First Name

DAVID

Middle

LEE

Last Name

COLGROVE

Suffix

Business Name

DAVID LEE COLGROVE MD

Original Issue Date

08/04/1998

Effective Date

08/04/1998

Expiration Date

07/31/2002

City

GALESBURG

State

Zip

61401

County

KNOX

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006