DAVID L PORTER DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****72

License Status

ACTIVE

Business

First Name

DAVID L

Last Name

PORTER

Suffix

Business Name

DAVID L PORTER DO

Original Issue Date

04/11/1996

Effective Date

07/04/2023

Expiration Date

07/31/2026

City

EAST PEORIA

State

Zip

61611

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/04/2023