JERALD EDWARD CUNDIFF MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****72

License Status

NOT RENEWED

Business

Title

First Name

JERALD

Middle

EDWARD

Last Name

CUNDIFF

Business Name

JERALD EDWARD CUNDIFF MD

Original Issue Date

07/24/2018

Effective Date

06/15/2020

Expiration Date

07/31/2023

City

DIXON

State

Zip

61021

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023