PARLEY W MADSEN III MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****54

License Status

NOT RENEWED

Business

First Name

PARLEY

Middle

Last Name

MADSEN

Suffix

III MD

Business Name

PARLEY W MADSEN III MD

Original Issue Date

01/06/1997

Effective Date

01/06/1997

Expiration Date

07/31/2002

City

GRANITE CITY

State

Zip

62040

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006