JACK F PRICE Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

LIMITED MEDICAL TEMPORARY PERMIT

License Number

130000252

License Status

EXPIRED

Business

First Name

JACK

Middle

Last Name

PRICE

Business Name

JACK F PRICE

Original Issue Date

08/16/1994

Effective Date

08/16/1994

Expiration Date

08/14/1997

City

EDWARDSVILLE

State

Zip

62025

County

MADISON

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

09/25/2006