CHARLES EDWARD PENNIX III MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

VISITING RESIDENT

License Number

188000575

License Status

CANCELLED

Business

Title

First Name

CHARLES

Middle

EDWARD

Last Name

PENNIX

Suffix

III

Business Name

CHARLES EDWARD PENNIX III MD

Original Issue Date

04/01/2014

Effective Date

04/01/2014

Expiration Date

09/30/2014

City

DECATUR

State

Zip

62521

County

MACON

Specialty/Qualifier

Emergency Medicine

Ever Disciplined

LastModifiedDate

03/13/2015