JOHN JACOB VERGHESE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****77

License Status

NOT RENEWED

Business

First Name

JOHN

Middle

JACOB

Last Name

VERGHESE

Suffix

Business Name

JOHN JACOB VERGHESE MD

Original Issue Date

12/07/1999

Effective Date

12/07/1999

Expiration Date

07/31/2005

City

CARLINVILLE

State

Zip

62626

County

MACOUPIN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2011