JONATHAN M FOSS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****59

License Status

NOT RENEWED

Business

First Name

JONATHAN M

Last Name

FOSS

Suffix

Business Name

JONATHAN M FOSS MD

Original Issue Date

09/16/1992

Effective Date

09/16/1992

Expiration Date

07/31/1996

City

SPRINGFIELD

State

Zip

62703

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020