GORDON L LARSEN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****75

License Status

NOT RENEWED

Business

First Name

GORDON L

Last Name

LARSEN

Suffix

Business Name

GORDON L LARSEN MD

Original Issue Date

10/19/1993

Effective Date

10/19/1993

Expiration Date

07/31/1996

City

PEORIA

State

Zip

61614

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006