JACK SPROUL MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****19

License Status

NOT RENEWED

Business

Title

First Name

JACK

Last Name

SPROUL

Business Name

JACK SPROUL MD

Original Issue Date

08/24/2022

Effective Date

08/24/2022

Expiration Date

07/31/2023

City

PONTIAC

State

Zip

54119

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023