LEO THAI MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****74

License Status

ACTIVE

Business

Title

First Name

LEO

Last Name

THAI

Business Name

LEO THAI MD

Original Issue Date

01/06/2022

Effective Date

07/25/2023

Expiration Date

07/31/2026

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/25/2023