KERYL JEAN GREEN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****56

License Status

NOT RENEWED

Business

First Name

KERYL

Middle

JEAN

Last Name

GREEN

Suffix

Business Name

KERYL JEAN GREEN MD

Original Issue Date

08/03/1999

Effective Date

08/03/1999

Expiration Date

07/31/2005

City

BELLEVILLE

State

Zip

62220

County

SAINT CLAIR

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020