CONSTANZA I FOX MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****02

License Status

NOT RENEWED

Business

First Name

CONSTANZA I

Last Name

FOX

Suffix

Business Name

CONSTANZA I FOX MD

Original Issue Date

08/17/1992

Effective Date

08/17/1992

Expiration Date

07/31/1996

City

CARBONDALE

State

Zip

62901

County

JACKSON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006