GERALD K CLAYCOMB MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****01

License Status

NOT RENEWED

Business

First Name

GERALD K

Last Name

CLAYCOMB

Suffix

Business Name

GERALD K CLAYCOMB MD

Original Issue Date

03/15/1995

Effective Date

03/15/1995

Expiration Date

07/31/1996

City

MACOMB

State

Zip

61455

County

MCDONOUGH

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006