THOMAS K AGBEMAPLE Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****76

License Status

NOT RENEWED

Business

First Name

THOMAS K

Last Name

AGBEMAPLE

Business Name

THOMAS K AGBEMAPLE

Original Issue Date

03/11/1992

Effective Date

03/11/1992

Expiration Date

07/31/2008

City

JACKSONVILLE

State

Zip

62650

County

MORGAN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/06/2008