JIASAN FU Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****24

License Status

NOT RENEWED

Business

First Name

JIASAN

Last Name

Business Name

JIASAN FU

Original Issue Date

02/01/2000

Effective Date

02/01/2000

Expiration Date

07/31/2002

City

BELLEVILLE

State

Zip

62226

County

SAINT CLAIR

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006