MARY JANE F KOHM MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****47

License Status

CANCELLED

Business

First Name

MARY JANE F

Last Name

KOHM

Suffix

Business Name

MARY JANE F KOHM MD

Original Issue Date

07/30/2002

Effective Date

07/30/2002

Expiration Date

07/31/2008

City

BELLEVILLE

State

Zip

62223

County

SAINT CLAIR

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/17/2008