JACK THOMAS SANDFORD MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036104428

License Status

INACTIVE

Business

First Name

JACK

Middle

THOMAS

Last Name

SANDFORD

Suffix

Business Name

JACK THOMAS SANDFORD MD

Original Issue Date

03/30/2001

Effective Date

04/25/2011

Expiration Date

07/31/2014

City

CARTERVILLE

State

Zip

62918

County

WILLIAMSON

Ever Disciplined

LastModifiedDate

04/08/2014