PRENTISS B CARTER III MD

Business Entity
NOT RENEWED

Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****62

NOT RENEWED

N

PRENTISS B

CARTER III

MD

PRENTISS B CARTER III MD

01/01/1997

05/14/2014

07/31/2017

PEORIA

IL

61614

PEORIA

II III IV V

N

11/01/2017