JEFFREY O PENTECOST Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125024891

License Status

EXPIRED

Business

First Name

JEFFREY

Middle

Last Name

PENTECOST

Business Name

JEFFREY O PENTECOST

Original Issue Date

05/21/1990

Effective Date

05/21/1990

Expiration Date

06/30/1993

City

PEORIA

State

Zip

61637

County

PEORIA

Specialty/Qualifier

Neurology

Ever Disciplined

LastModifiedDate

09/22/2006