JACK A LAURIE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****38

License Status

NOT RENEWED

Business

First Name

JACK A

Last Name

LAURIE

Suffix

Business Name

JACK A LAURIE MD

Original Issue Date

08/23/1982

Effective Date

08/23/1982

Expiration Date

07/31/1987

City

BENTON

State

Zip

62812

County

FRANKLIN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006