JONATHAN SALAS SAGUM 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

JONATHAN

Middle

SALAS

Last Name

SAGUM

Business Name

JONATHAN SALAS SAGUM MD

Original Issue Date

07/25/2008

Effective Date

02/10/2015

Expiration Date

07/31/2017

City

SPRINGFIELD

State

Zip

62702

County

SANGAMON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017