JASON BRADLEY TERRELL MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****74

License Status

NOT RENEWED

Business

Title

First Name

JASON

Middle

BRADLEY

Last Name

TERRELL

Business Name

JASON BRADLEY TERRELL MD

Original Issue Date

10/26/2012

Effective Date

06/18/2014

Expiration Date

07/31/2017

City

LOVES PARK

State

Zip

61111

County

WINNEBAGO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

11/01/2017