JOHN T PORVAZNIK Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****40

License Status

CANCELLED

Business

First Name

JOHN T

Last Name

PORVAZNIK

Business Name

JOHN T PORVAZNIK

Original Issue Date

05/28/1998

Effective Date

05/28/1998

Expiration Date

07/31/1999

City

VANDALIA

State

Zip

62471

County

CLINTON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006