LEONCIO S DIZON Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****95

License Status

ACTIVE

Business

First Name

LEONCIO S

Last Name

DIZON

Business Name

LEONCIO S DIZON

Original Issue Date

08/30/1995

Effective Date

06/29/2023

Expiration Date

07/31/2026

City

JERSEYVILLE

State

Zip

62052

County

JERSEY

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/29/2023