JASON ALEXANDER GLENN MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****22

License Status

ACTIVE

Business

Title

First Name

JASON

Middle

ALEXANDER

Last Name

GLENN

Business Name

JASON ALEXANDER GLENN MD

Original Issue Date

05/14/2024

Effective Date

05/14/2024

Expiration Date

07/31/2026

City

MATTOON

State

Zip

61938

County

COLES

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/14/2024