LORI L PEGRAM MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****55

License Status

NOT RENEWED

Business

First Name

LORI L

Last Name

PEGRAM

Suffix

Business Name

LORI L PEGRAM MD

Original Issue Date

04/08/1987

Effective Date

08/13/2014

Expiration Date

07/31/2017

City

BLOOMINGTON

State

Zip

61701

County

MCLEAN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017