JOSEPH DONALD COONROD MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****63

License Status

CANCELLED

Business

First Name

JOSEPH

Middle

DONALD

Last Name

COONROD

Suffix

Business Name

JOSEPH DONALD COONROD MD

Original Issue Date

01/04/2002

Effective Date

01/04/2002

Expiration Date

07/31/2005

City

SPRINGFIELD

State

Zip

62702

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006