WALTER A FORRED JR MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****35

License Status

NOT RENEWED

Business

First Name

WALTER A

Last Name

FORRED JR

Suffix

Business Name

WALTER A FORRED JR MD

Original Issue Date

06/09/1994

Effective Date

06/09/1994

Expiration Date

07/31/1999

City

PEORIA

State

Zip

61603

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006