WILLIAM TODD BOHANNON MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****54

License Status

CANCELLED

Business

First Name

WILLIAM

Middle

TODD

Last Name

BOHANNON

Suffix

Business Name

WILLIAM TODD BOHANNON MD

Original Issue Date

06/22/1999

Effective Date

06/22/1999

Expiration Date

07/31/2002

City

SPRINGFIELD

State

Zip

62781

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006