QUENTIN BLACKSHEAR ALLEN 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

QUENTIN

Middle

BLACKSHEAR

Last Name

ALLEN

Suffix

Business Name

QUENTIN BLACKSHEAR ALLEN MD

Original Issue Date

08/08/2006

Effective Date

08/08/2006

Expiration Date

07/31/2008

City

PEORIA

State

Zip

61614

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2011