RAELENE H LARSON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****49

License Status

NOT RENEWED

Business

First Name

RAELENE H

Last Name

LARSON

Suffix

Business Name

RAELENE H LARSON MD

Original Issue Date

08/21/1986

Effective Date

08/21/1986

Expiration Date

07/31/1990

City

PEORIA

State

Zip

61614

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006