KRISTOFFER DAVID PEPPERELL MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****80

License Status

NOT RENEWED

Business

First Name

KRISTOFFER

Middle

DAVID

Last Name

PEPPERELL

Suffix

Business Name

KRISTOFFER DAVID PEPPERELL MD

Original Issue Date

06/08/2004

Effective Date

06/08/2004

Expiration Date

07/31/2008

City

PEORIA

State

Zip

61615

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/06/2008