JARROD CLARKE HENDERSON WALL MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****77

License Status

ACTIVE

Business

Title

First Name

JARROD

Middle

CLARKE HENDERSON

Last Name

WALL

Business Name

JARROD CLARKE HENDERSON WALL MD

Original Issue Date

09/10/2008

Effective Date

04/18/2023

Expiration Date

07/31/2026

City

SPRINGFIELD

State

Zip

62794

County

SANGAMON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/18/2023