ROGER L WITTUM 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

ROGER L

Last Name

WITTUM

Suffix

Business Name

ROGER L WITTUM MD

Original Issue Date

06/27/1985

Effective Date

06/27/1985

Expiration Date

07/31/1987

City

PEORIA

State

Zip

61603

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006