ALFRED W MAZUR MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****41

License Status

NOT RENEWED

Business

First Name

ALFRED

Middle

Last Name

MAZUR

Suffix

Business Name

ALFRED W MAZUR MD

Original Issue Date

03/15/2006

Effective Date

06/23/2008

Expiration Date

07/31/2011

City

GALESBURG

State

Zip

61401

County

KNOX

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/10/2011