DAVID JOEL PERNIKOFF MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****16

License Status

NOT RENEWED

Business

First Name

DAVID

Middle

JOEL

Last Name

PERNIKOFF

Suffix

Business Name

DAVID JOEL PERNIKOFF MD

Original Issue Date

03/26/2001

Effective Date

03/26/2001

Expiration Date

07/31/2005

City

GRANITE CITY

State

Zip

62040

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006