GRACE MARIA THEODORO MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****44

License Status

NOT RENEWED

Business

First Name

GRACE MARIA

Last Name

THEODORO

Suffix

Business Name

GRACE MARIA THEODORO MD

Original Issue Date

01/01/1997

Expiration Date

07/31/2002

City

ALTON

State

Zip

62002

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006