ROBERT L PENDERGAST MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****71

License Status

NOT RENEWED

Business

First Name

ROBERT

Middle

Last Name

PENDERGAST

Suffix

Business Name

ROBERT L PENDERGAST MD

Original Issue Date

08/31/1998

Effective Date

08/31/1998

Expiration Date

07/31/2002

City

DECATUR

State

Zip

62526

County

MACON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006