TIMOTHY VIRGIL JARDELEZA MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****90

License Status

ACTIVE

Business

Title

First Name

TIMOTHY

Middle

VIRGIL

Last Name

JARDELEZA

Business Name

TIMOTHY VIRGIL JARDELEZA MD

Original Issue Date

12/28/2022

Effective Date

05/20/2023

Expiration Date

07/31/2026

City

BELLEVILLE

State

Zip

62226

County

SAINT CLAIR

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/20/2023