LIZA ANTOINETTE JAIN PHU 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

Title

First Name

LIZA ANTOINETTE

Middle

JAIN

Last Name

PHU

Business Name

LIZA ANTOINETTE JAIN PHU MD

Original Issue Date

10/05/2011

Effective Date

05/12/2014

Expiration Date

07/31/2017

City

DECATUR

State

Zip

62521

County

MACON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017