JACQUELINE R JAYNE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****79

License Status

NOT RENEWED

Business

First Name

JACQUELINE R

Last Name

JAYNE

Suffix

Business Name

JACQUELINE R JAYNE MD

Original Issue Date

08/19/1993

Effective Date

08/19/1993

Expiration Date

07/31/2005

City

BLOOMINGTON

State

Zip

61701

County

MCLEAN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006