JIMMY LYLE CROUSE 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

First Name

JIMMY LYLE

Last Name

CROUSE

Suffix

Business Name

JIMMY LYLE CROUSE MD

Original Issue Date

01/01/1997

Expiration Date

07/31/2005

City

CARBONDALE

State

Zip

62901

County

JACKSON

Controlled Substance Schedule

II III IV

Ever Disciplined

LastModifiedDate

04/07/2011