PAUL W HUMPHREY MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****82

License Status

CANCELLED

Business

First Name

PAUL W

Last Name

HUMPHREY

Suffix

Business Name

PAUL W HUMPHREY MD

Original Issue Date

08/12/1987

Effective Date

08/12/1987

Expiration Date

07/31/1990

City

PEORIA

State

Zip

61637

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006