DARRYL ANTHONY GREEN MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125042595

License Status

EXPIRED

Business

First Name

DARRYL

Middle

ANTHONY

Last Name

GREEN

Suffix

Business Name

DARRYL ANTHONY GREEN MD

Original Issue Date

07/01/2001

Effective Date

07/01/2001

Expiration Date

06/30/2004

City

CARBONDALE

State

Zip

62901

County

JACKSON

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006