JASON R MATTINGLY MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****91

License Status

NOT RENEWED

Business

First Name

JASON

Middle

Last Name

MATTINGLY

Suffix

Business Name

JASON R MATTINGLY MD

Original Issue Date

09/24/2001

Effective Date

09/24/2001

Expiration Date

07/31/2002

City

PEORIA

State

Zip

61602

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006