JERRY MICHAEL SPECKMAN MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****31

License Status

CANCELLED

Business

First Name

JERRY

Middle

MICHAEL

Last Name

SPECKMAN

Suffix

Business Name

JERRY MICHAEL SPECKMAN MD

Original Issue Date

12/03/1998

Effective Date

12/03/1998

Expiration Date

07/31/2002

City

SPRINGFIELD

State

Zip

62781

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006