JEFFREY WAYNE CHILDERS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****80

License Status

NOT RENEWED

Business

First Name

JEFFREY

Middle

WAYNE

Last Name

CHILDERS

Suffix

Business Name

JEFFREY WAYNE CHILDERS MD

Original Issue Date

12/19/2000

Effective Date

12/19/2000

Expiration Date

07/31/2008

City

QUINCY

State

Zip

62301

County

ADAMS

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/06/2008