JASON MILLER ANANE SEFAH MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****70

License Status

NOT RENEWED

Business

Title

First Name

JASON

Middle

MILLER

Last Name

ANANE SEFAH

Business Name

JASON MILLER ANANE SEFAH MD

Original Issue Date

06/18/2009

Effective Date

04/20/2017

Expiration Date

09/30/2020

City

PEORIA

State

Zip

61605

County

PEORIA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021