JENNIFER NICOLE THOMPSON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****75

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

08/02/2012

Expiration Date

07/31/2014

City

EAST PEORIA

State

Zip

61611

County

TAZEWELL

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020