RYAN P WALSH 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

RYAN

Middle

Last Name

WALSH

Suffix

Business Name

RYAN P WALSH MD

Original Issue Date

06/30/2004

Effective Date

04/22/2014

Expiration Date

07/31/2017

City

PEORIA

State

Zip

61602

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017