DOUGLAS CHARLES BROWN Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125052346

License Status

CANCELLED

Business

First Name

DOUGLAS

Middle

CHARLES

Last Name

BROWN

Business Name

DOUGLAS CHARLES BROWN

Original Issue Date

07/01/2007

Effective Date

07/01/2007

Expiration Date

06/30/2010

City

CARBONDALE

State

Zip

62901

County

JACKSON

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

04/23/2007