SUSAN MARY TUCKER MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****42

License Status

NOT RENEWED

Business

First Name

SUSAN MARY

Last Name

TUCKER

Suffix

Business Name

SUSAN MARY TUCKER MD

Original Issue Date

06/03/1994

Effective Date

06/03/1994

Expiration Date

07/31/1996

City

SPRINGFIELD

State

Zip

62769

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006