FREDERICK PUGH HAYNES MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****85

License Status

NOT RENEWED

Business

First Name

FREDERICK PUGH

Last Name

HAYNES

Suffix

Business Name

FREDERICK PUGH HAYNES MD

Original Issue Date

01/01/1997

Effective Date

07/11/2017

Expiration Date

09/30/2020

City

CHAMPAIGN

State

Zip

61820

County

CHAMPAIGN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021