JASON RODNEY SUSONG MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****93

License Status

NOT RENEWED

Business

Title

First Name

JASON

Middle

RODNEY

Last Name

SUSONG

Business Name

JASON RODNEY SUSONG MD

Original Issue Date

11/01/2012

Effective Date

11/01/2012

Expiration Date

07/31/2014

City

SCOTT AFB

State

Zip

62225

County

SAINT CLAIR

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014