DANIEL MAYER MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****99

License Status

CANCELLED

Business

First Name

DANIEL

Last Name

MAYER

Suffix

Business Name

DANIEL MAYER MD

Original Issue Date

02/06/2003

Effective Date

02/06/2003

Expiration Date

07/31/2005

City

SPRINGFIELD

State

Zip

62703

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006