LEROY H SPALT 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

LEROY H

Last Name

SPALT

Suffix

Business Name

LEROY H SPALT MD

Original Issue Date

05/04/1995

Effective Date

05/04/1995

Expiration Date

07/31/1999

City

CARBONDALE

State

Zip

62901

County

JACKSON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/12/2017