SUSAN JASON DEGUIDE MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****78

License Status

ACTIVE

Business

First Name

SUSAN

Middle

JASON

Last Name

DEGUIDE

Suffix

Business Name

SUSAN JASON DEGUIDE MD

Original Issue Date

06/15/1999

Effective Date

07/06/2023

Expiration Date

07/31/2026

City

ROCKFORD

State

Zip

61103

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/06/2023