LAURA M FALL Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****10

License Status

NOT RENEWED

Business

First Name

LAURA M

Last Name

FALL

Business Name

LAURA M FALL

Original Issue Date

04/28/1992

Effective Date

04/28/1992

Expiration Date

07/31/1993

City

CARBONDALE

State

Zip

62901

County

JACKSON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006