LEONCIO S DIZON Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****96

License Status

NOT RENEWED

Business

First Name

LEONCIO S

Last Name

DIZON

Business Name

LEONCIO S DIZON

Original Issue Date

09/09/1996

Effective Date

09/09/1996

Expiration Date

07/31/1999

City

ROODHOUSE

State

Zip

62082

County

GREENE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020