JESSIE D TE Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****72

License Status

CANCELLED

Business

First Name

JESSIE D

Last Name

Business Name

JESSIE D TE

Original Issue Date

10/30/1995

Effective Date

10/30/1995

Expiration Date

07/31/2002

City

CHRISTOPHER

State

Zip

62822

County

FRANKLIN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006