PATRICIA A DETERS Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****69

License Status

NOT RENEWED

Business

First Name

PATRICIA A

Last Name

DETERS

Business Name

PATRICIA A DETERS

Original Issue Date

06/29/1997

Effective Date

06/29/1997

Expiration Date

07/31/2005

City

PEORIA

State

Zip

61637

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020