LARRY J DAVIS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****79

License Status

NOT RENEWED

Business

First Name

LARRY J

Last Name

DAVIS

Suffix

Business Name

LARRY J DAVIS MD

Original Issue Date

12/06/1984

Effective Date

05/04/2017

Expiration Date

09/30/2020

City

QUINCY

State

Zip

62305

County

ADAMS

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021