SUSAN JEANNE EAGAN MD 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

SUSAN

Middle

JEANNE

Last Name

EAGAN

Suffix

Business Name

SUSAN JEANNE EAGAN MD

Original Issue Date

08/21/1998

Effective Date

06/10/2008

Expiration Date

07/31/2011

City

CHAMPAIGN

State

Zip

61821

County

CHAMPAIGN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/10/2011