JEFFREY STEPHEN EARHART MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****45

License Status

NOT RENEWED

Business

Title

First Name

JEFFREY

Middle

STEPHEN

Last Name

EARHART

Business Name

JEFFREY STEPHEN EARHART MD

Original Issue Date

09/18/2014

Effective Date

09/18/2014

Expiration Date

07/31/2017

City

ROCKFORD

State

Zip

61114

County

WINNEBAGO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020