JACK W LENOX MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****67

License Status

ACTIVE

Business

First Name

JACK W

Last Name

LENOX

Suffix

Business Name

JACK W LENOX MD

Original Issue Date

02/09/1984

Effective Date

05/25/2023

Expiration Date

07/31/2026

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/25/2023