CHARLENE MARIE PRATHER MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****74

License Status

CANCELLED

Business

Title

First Name

CHARLENE

Middle

MARIE

Last Name

PRATHER

Business Name

CHARLENE MARIE PRATHER MD

Original Issue Date

09/02/1999

Effective Date

09/02/1999

Expiration Date

07/31/2002

City

DU QUOIN

State

Zip

62832

County

PERRY

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006