SHANDA L RILEY Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****31

License Status

NOT RENEWED

Business

First Name

SHANDA

Middle

Last Name

RILEY

Business Name

SHANDA L RILEY

Original Issue Date

08/13/2004

Effective Date

08/13/2004

Expiration Date

07/31/2005

City

PEORIA

State

Zip

61637

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006