ELEATHA L SURRATT MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****50

License Status

NOT RENEWED

Business

First Name

ELEATHA

Middle

Last Name

SURRATT

Suffix

Business Name

ELEATHA L SURRATT MD

Original Issue Date

07/23/1992

Effective Date

07/23/1992

Expiration Date

07/31/1993

City

CHAMPAIGN

State

Zip

61820

County

CHAMPAIGN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020