LARRY T GLASS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****99

License Status

NOT RENEWED

Business

First Name

LARRY T

Last Name

GLASS

Suffix

Business Name

LARRY T GLASS MD

Original Issue Date

06/30/1986

Effective Date

06/30/1986

Expiration Date

07/31/1990

City

CHAMPAIGN

State

Zip

61820

County

CHAMPAIGN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006