SUSAN J COLE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****64

License Status

NOT RENEWED

Business

First Name

SUSAN

Middle

Last Name

COLE

Suffix

Business Name

SUSAN J COLE MD

Original Issue Date

03/07/2002

Effective Date

03/07/2002

Expiration Date

07/31/2005

City

PEORIA

State

Zip

61615

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020