JACK JOSEPH AMJA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****92

License Status

NOT RENEWED

Business

Title

First Name

JACK

Middle

JOSEPH

Last Name

AMJA

Business Name

JACK JOSEPH AMJA MD

Original Issue Date

05/13/2020

Effective Date

05/13/2020

Expiration Date

07/31/2023

City

MANCHESTER

State

Zip

06042

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023