DAVID ALAN THEODORO MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****72

License Status

NOT RENEWED

Business

First Name

DAVID ALAN

Last Name

THEODORO

Suffix

Business Name

DAVID ALAN THEODORO MD

Original Issue Date

06/23/1997

Effective Date

06/23/1997

Expiration Date

07/31/2008

City

SWANSEA

State

Zip

62226

County

SAINT CLAIR

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/06/2008