GLEN KEITH GEREMIA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****32

License Status

NOT RENEWED

Business

First Name

GLEN KEITH

Last Name

GEREMIA

Suffix

Business Name

GLEN KEITH GEREMIA MD

Original Issue Date

10/04/2005

Effective Date

10/04/2005

Expiration Date

07/31/2008

City

BLOOMINGTON

State

Zip

61701

County

MCLEAN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020