DONNA PROHAZKA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****41

License Status

NOT RENEWED

Business

Title

First Name

DONNA

Last Name

PROHAZKA

Business Name

DONNA PROHAZKA MD

Original Issue Date

03/02/2007

Effective Date

03/02/2007

Expiration Date

07/31/2008

City

CARBONDALE

State

Zip

62901

County

JACKSON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2011