RANDOLFO DE LEON 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

RANDOLFO

Last Name

DE LEON

Business Name

RANDOLFO DE LEON

Original Issue Date

05/12/1992

Effective Date

05/12/1992

Expiration Date

07/31/1993

City

WINCHESTER

State

Zip

62694

County

SCOTT

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/12/2017