JONATHAN B VASQUEZ Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****29

License Status

NOT RENEWED

Business

First Name

JONATHAN

Middle

Last Name

VASQUEZ

Business Name

JONATHAN B VASQUEZ

Original Issue Date

05/19/2005

Effective Date

04/08/2011

Expiration Date

07/31/2014

City

DECATUR

State

Zip

62521

County

MACON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/12/2017