DOUGLAS PETER FORGIT MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****43

License Status

NOT RENEWED

Business

Title

First Name

DOUGLAS

Middle

PETER

Last Name

FORGIT

Business Name

DOUGLAS PETER FORGIT MD

Original Issue Date

09/08/2014

Effective Date

09/08/2014

Expiration Date

07/31/2017

City

CARBONDALE

State

Zip

62901

County

JACKSON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017