ROBERT LEE PRENTICE MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****89

License Status

CANCELLED

Business

First Name

ROBERT LEE

Last Name

PRENTICE

Suffix

Business Name

ROBERT LEE PRENTICE MD

Original Issue Date

01/01/1997

Effective Date

06/16/2008

Expiration Date

07/31/2011

City

SPRINGFIELD

State

Zip

62702

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2011