JON O HUMPHREY Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125036531

License Status

EXPIRED

Business

First Name

JON

Middle

Last Name

HUMPHREY

Business Name

JON O HUMPHREY

Original Issue Date

06/10/1997

Effective Date

06/10/1997

Expiration Date

08/03/2000

City

SPRINGFIELD

State

Zip

62794

County

SANGAMON

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006