TERRY JOE REARDON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****13

License Status

NOT RENEWED

Business

First Name

TERRY

Middle

JOE

Last Name

REARDON

Suffix

Business Name

TERRY JOE REARDON MD

Original Issue Date

05/24/1999

Effective Date

05/24/1999

Expiration Date

07/31/2002

City

MATTOON

State

Zip

61938

County

COLES

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006