JEFFERSON MASON TRUPP MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****33

License Status

ACTIVE

Business

Title

First Name

JEFFERSON

Middle

MASON

Last Name

TRUPP

Business Name

JEFFERSON MASON TRUPP MD

Original Issue Date

08/13/2024

Effective Date

08/13/2024

Expiration Date

07/31/2026

City

PEORIA

State

Zip

61636

County

PEORIA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/13/2024