JUDITH F DEBOSE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****20

License Status

NOT RENEWED

Business

First Name

JUDITH

Middle

Last Name

DEBOSE

Suffix

Business Name

JUDITH F DEBOSE MD

Original Issue Date

09/16/2005

Effective Date

06/27/2008

Expiration Date

07/31/2011

City

ALTON

State

Zip

62002

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/10/2011