JERRY LYNN GODDARD MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****27

License Status

NOT RENEWED

Business

First Name

JERRY LYNN

Last Name

GODDARD

Suffix

Business Name

JERRY LYNN GODDARD MD

Original Issue Date

12/01/1988

Effective Date

12/01/1988

Expiration Date

07/31/1993

City

CARBONDALE

State

Zip

62901

County

JACKSON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020