CHARLES G FARNUM MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****76

License Status

CANCELLED

Business

First Name

CHARLES G

Last Name

FARNUM

Suffix

Business Name

CHARLES G FARNUM MD

Original Issue Date

01/01/1997

Expiration Date

09/01/1982

City

PEORIA

State

Zip

61636

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006