JAMES DANIEL RAQUE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****34

License Status

NOT RENEWED

Business

First Name

JAMES

Middle

DANIEL

Last Name

RAQUE

Suffix

Business Name

JAMES DANIEL RAQUE MD

Original Issue Date

07/16/2002

Effective Date

07/16/2002

Expiration Date

07/31/2005

City

GALENA

State

Zip

61036

County

JO DAVIESS

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006