THOMAS R BOXLEITER MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****38

License Status

NOT RENEWED

Business

First Name

THOMAS R

Last Name

BOXLEITER

Suffix

Business Name

THOMAS R BOXLEITER MD

Original Issue Date

07/16/1996

Effective Date

06/29/2017

Expiration Date

09/30/2020

City

GALENA

State

Zip

61036

County

JO DAVIESS

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021