QUENTIN BLACKSHEAR ALLEN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****73

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

04/20/2011

Expiration Date

07/31/2014

City

PEORIA

State

Zip

61615

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014