BRIAN PHILLIP DANIEL MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****86

License Status

CANCELLED

Business

First Name

BRIAN PHILLIP

Last Name

DANIEL

Suffix

Business Name

BRIAN PHILLIP DANIEL MD

Original Issue Date

04/17/1995

Effective Date

04/17/1995

Expiration Date

07/31/2005

City

BYRON

State

Zip

61010

County

OGLE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006