BRIAN M YAGODA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****30

License Status

NOT RENEWED

Business

First Name

BRIAN M

Last Name

YAGODA

Suffix

Business Name

BRIAN M YAGODA MD

Original Issue Date

11/12/1987

Effective Date

11/12/1987

Expiration Date

07/31/1996

City

PEKIN

State

Zip

61554

County

TAZEWELL

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006