COREY P MASSEY Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****70

License Status

CANCELLED

Business

First Name

COREY

Middle

Last Name

MASSEY

Business Name

COREY P MASSEY

Original Issue Date

10/21/2002

Effective Date

10/21/2002

Expiration Date

07/31/2005

City

PEORIA

State

Zip

61637

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006