DAN D LE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****98

License Status

NOT RENEWED

Business

Title

First Name

DAN

Middle

Last Name

Business Name

DAN D LE MD

Original Issue Date

07/16/2018

Effective Date

07/16/2018

Expiration Date

09/30/2020

City

CARBONDALE

State

Zip

62901

County

JACKSON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021