ISAAC A LOOSE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****76

License Status

NOT RENEWED

Business

First Name

ISAAC A

Last Name

LOOSE

Suffix

Business Name

ISAAC A LOOSE MD

Original Issue Date

07/11/1996

Effective Date

07/11/1996

Expiration Date

07/31/1999

City

DIXON

State

Zip

61021

County

LEE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006