THOMAS S DOUGLASS III Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****86

License Status

NOT RENEWED

Business

First Name

THOMAS S

Last Name

DOUGLASS III

Business Name

THOMAS S DOUGLASS III

Original Issue Date

11/24/1992

Effective Date

11/24/1992

Expiration Date

07/31/1996

City

MOLINE

State

Zip

61265

County

ROCK ISLAND

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006