ANTHONY RAOUL JEANMENNE MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125055922

License Status

EXPIRED

Business

First Name

ANTHONY

Middle

RAOUL

Last Name

JEANMENNE

Suffix

Business Name

ANTHONY RAOUL JEANMENNE MD

Original Issue Date

06/26/2012

Effective Date

06/26/2012

Expiration Date

06/25/2014

City

SPRINGFIELD

State

Zip

62701

County

SANGAMON

Specialty/Qualifier

Diagnostic Radiology

Ever Disciplined

LastModifiedDate

03/13/2015