FIRTH S SPIEGEL Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****30

License Status

CANCELLED

Business

First Name

FIRTH S

Last Name

SPIEGEL

Business Name

FIRTH S SPIEGEL

Original Issue Date

12/09/2002

Effective Date

12/09/2002

Expiration Date

07/31/2005

City

MOUNT VERNON

State

Zip

62864

County

JEFFERSON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006