DALILA WATFORD LEWIS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****90

License Status

NOT RENEWED

Business

Title

First Name

DALILA

Middle

WATFORD

Last Name

LEWIS

Business Name

DALILA WATFORD LEWIS MD

Original Issue Date

11/01/2018

Effective Date

11/01/2018

Expiration Date

09/30/2020

City

ROCKFORD

State

Zip

61104

County

WINNEBAGO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021