JERRY J TRACY III MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****66

License Status

NOT RENEWED

Business

First Name

JERRY

Middle

Last Name

TRACY

Suffix

III MD

Business Name

JERRY J TRACY III MD

Original Issue Date

07/16/1998

Effective Date

07/16/1998

Expiration Date

07/31/2002

City

PEORIA

State

Zip

61636

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006