REBECCA L TAKAHASHI 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

First Name

REBECCA

Middle

Last Name

TAKAHASHI

Suffix

Business Name

REBECCA L TAKAHASHI MD

Original Issue Date

06/13/2001

Effective Date

06/13/2001

Expiration Date

07/31/2005

City

PEORIA

State

Zip

61615

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006