JERRY LYNN GODDARD 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

JERRY LYNN

Last Name

GODDARD

Suffix

Business Name

JERRY LYNN GODDARD MD

Original Issue Date

01/01/1997

Effective Date

04/14/2023

Expiration Date

07/31/2026

City

CARBONDALE

State

Zip

62901

County

JACKSON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/14/2023