CHAD JEREMY POTTER MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****90

License Status

NOT RENEWED

Business

First Name

CHAD

Middle

JEREMY

Last Name

POTTER

Suffix

Business Name

CHAD JEREMY POTTER MD

Original Issue Date

06/30/2006

Effective Date

06/30/2006

Expiration Date

07/31/2008

City

CARBONDALE

State

Zip

62901

County

JACKSON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/06/2008