ROEL CONRAD ENERIO JAMIS 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

Title

First Name

ROEL

Middle

CONRAD ENERIO

Last Name

JAMIS

Business Name

ROEL CONRAD ENERIO JAMIS MD

Original Issue Date

08/27/2013

Effective Date

06/06/2017

Expiration Date

09/30/2020

City

MATTOON

State

Zip

61938

County

COLES

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

01/14/2021