LARRY L WELLENDORF II 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

LARRY L

Last Name

WELLENDORF II

Business Name

LARRY L WELLENDORF II

Original Issue Date

06/30/2005

Effective Date

06/30/2005

Expiration Date

07/31/2008

City

DE KALB

State

Zip

60115

County

DEKALB

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020