CARLOS A LECCA Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****39

License Status

NOT RENEWED

Business

First Name

CARLOS A

Last Name

LECCA

Business Name

CARLOS A LECCA

Original Issue Date

08/15/1996

Effective Date

07/19/2011

Expiration Date

07/31/2014

City

CHESTER

State

Zip

62233

County

RANDOLPH

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020