DIANA I DOLL MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****48

License Status

NOT RENEWED

Business

First Name

DIANA I

Last Name

DOLL

Suffix

Business Name

DIANA I DOLL MD

Original Issue Date

06/09/1993

Effective Date

05/27/2011

Expiration Date

07/31/2014

City

PEORIA

State

Zip

61602

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014