JACK R PERRY MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****15

License Status

NOT RENEWED

Business

Title

First Name

JACK

Middle

Last Name

PERRY

Business Name

JACK R PERRY MD

Original Issue Date

06/04/2015

Effective Date

06/04/2015

Expiration Date

07/31/2017

City

FORT WALTON BEACH

State

Zip

32548

County

FLORIDA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017