MARK THOMAS JENNINGS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****95

License Status

NOT RENEWED

Business

First Name

MARK THOMAS

Last Name

JENNINGS

Suffix

Business Name

MARK THOMAS JENNINGS MD

Original Issue Date

07/08/2003

Effective Date

05/11/2011

Expiration Date

07/31/2014

City

PEORIA

State

Zip

61637

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014