M TERESA C FRASER 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

M TERESA

Middle

Last Name

FRASER

Business Name

M TERESA C FRASER

Original Issue Date

09/29/1994

Effective Date

06/06/2023

Expiration Date

07/31/2026

City

PEORIA

State

Zip

61603

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/06/2023