DOUGLAS JACK FREEMAN Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****04

License Status

NOT RENEWED

Business

First Name

DOUGLAS

Middle

JACK

Last Name

FREEMAN

Business Name

DOUGLAS JACK FREEMAN

Original Issue Date

03/12/2002

Effective Date

03/12/2002

Expiration Date

07/31/2005

City

HIGHLAND

State

Zip

62249

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006