JENNIFER MARY FAUNTLEROY MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036059513

License Status

NOT RENEWED

Business

First Name

JENNIFER MARY

Last Name

FAUNTLEROY

Suffix

Business Name

JENNIFER MARY FAUNTLEROY MD

Original Issue Date

09/25/1979

Effective Date

09/25/1979

Expiration Date

07/31/1984

City

CARBONDALE

State

Zip

62901

County

JACKSON

Ever Disciplined

LastModifiedDate

09/20/2006