DAVID R LEVINE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****58

License Status

NOT RENEWED

Business

First Name

DAVID R

Last Name

LEVINE

Suffix

Business Name

DAVID R LEVINE MD

Original Issue Date

06/30/1986

Effective Date

06/12/2008

Expiration Date

07/31/2011

City

ROCKFORD

State

Zip

61103

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/10/2011