DAVID L LEADER JR DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****77

License Status

NOT RENEWED

Business

First Name

DAVID L

Last Name

LEADER JR

Suffix

Business Name

DAVID L LEADER JR DO

Original Issue Date

07/25/1995

Effective Date

07/25/1995

Expiration Date

07/31/1996

City

PEORIA

State

Zip

61637

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006