THEODORE C LO 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

THEODORE

Middle

Last Name

Suffix

Business Name

THEODORE C LO MD

Original Issue Date

10/16/2001

Effective Date

10/16/2001

Expiration Date

07/31/2008

City

PEORIA

State

Zip

61604

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020