JENNIFER NICOLE THOMPSON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****73

License Status

NOT RENEWED

Business

Title

First Name

JENNIFER

Middle

NICOLE

Last Name

THOMPSON

Business Name

JENNIFER NICOLE THOMPSON MD

Original Issue Date

08/02/2012

Effective Date

06/14/2017

Expiration Date

09/30/2020

City

BLOOMINGTON

State

Zip

61701

County

MCLEAN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021