ITA SEGAL MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****39

License Status

NOT RENEWED

Business

First Name

ITA

Last Name

SEGAL

Suffix

Business Name

ITA SEGAL MD

Original Issue Date

08/24/1998

Effective Date

08/24/1998

Expiration Date

07/31/1999

City

MOUNT VERNON

State

Zip

62864

County

JEFFERSON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006