JON O HUMPHREY Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****26

License Status

NOT RENEWED

Business

First Name

JON

Middle

Last Name

HUMPHREY

Business Name

JON O HUMPHREY

Original Issue Date

06/22/2007

Effective Date

03/30/2021

Expiration Date

07/31/2023

City

CARBONDALE

State

Zip

62902

County

JACKSON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023