THOMAS J CONNOLLY Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****57

License Status

NOT RENEWED

Business

First Name

THOMAS J

Last Name

CONNOLLY

Business Name

THOMAS J CONNOLLY

Original Issue Date

02/02/1996

Effective Date

02/02/1996

Expiration Date

07/31/1996

City

EAST ST LOUIS

State

Zip

62201

County

SAINT CLAIR

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006