PATRICK T TRACY MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****81

License Status

NOT RENEWED

Business

First Name

PATRICK T

Last Name

TRACY

Suffix

Business Name

PATRICK T TRACY MD

Original Issue Date

09/17/1984

Effective Date

06/15/2020

Expiration Date

07/31/2023

City

PEORIA

State

Zip

61603

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023