JACK LESTER CROUGHAN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036110876

License Status

NOT RENEWED

Business

First Name

JACK

Middle

LESTER

Last Name

CROUGHAN

Suffix

Business Name

JACK LESTER CROUGHAN MD

Original Issue Date

02/27/2004

Effective Date

06/13/2014

Expiration Date

07/31/2017

City

GRANITE CITY

State

Zip

62040

County

MADISON

Ever Disciplined

LastModifiedDate

11/01/2017