JACK P SPANIOL MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****26

License Status

ACTIVE

Business

First Name

JACK P

Last Name

SPANIOL

Suffix

Business Name

JACK P SPANIOL MD

Original Issue Date

06/24/1988

Effective Date

05/03/2023

Expiration Date

07/31/2026

City

BLOOMINGTON

State

Zip

61701

County

MCLEAN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/03/2023