WANDA F DAVIS 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

WANDA F

Last Name

DAVIS

Suffix

Business Name

WANDA F DAVIS MD

Original Issue Date

06/12/1991

Effective Date

06/12/1991

Expiration Date

07/31/2008

City

PEORIA

State

Zip

61604

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/06/2008