LUTHER TERRANCE PRINCE III MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****92

License Status

NOT RENEWED

Business

First Name

LUTHER

Middle

TERRANCE

Last Name

PRINCE

Suffix

III MD

Business Name

LUTHER TERRANCE PRINCE III MD

Original Issue Date

03/24/1997

Effective Date

03/24/1997

Expiration Date

07/31/1999

City

ROCKFORD

State

Zip

61103

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006