MARY G JOSEPH 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

First Name

MARY G

Last Name

JOSEPH

Suffix

Business Name

MARY G JOSEPH MD

Original Issue Date

11/20/1996

Effective Date

11/20/1996

Expiration Date

07/31/2005

City

STAUNTON

State

Zip

62088

County

MACOUPIN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006