JEROME DAVID COHEN MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****26

License Status

CANCELLED

Business

First Name

JEROME DAVID

Last Name

COHEN

Suffix

Business Name

JEROME DAVID COHEN MD

Original Issue Date

01/29/1997

Effective Date

01/29/1997

Expiration Date

07/31/2005

City

DUQUOIN

State

Zip

62837

County

WAYNE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006