PUSHPA A JOSEPH MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****61

License Status

NOT RENEWED

Business

First Name

PUSHPA A

Last Name

JOSEPH

Suffix

Business Name

PUSHPA A JOSEPH MD

Original Issue Date

01/19/1984

Effective Date

05/26/2014

Expiration Date

07/31/2017

City

PEORIA

State

Zip

61614

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017