JENNIFER MARY FAUNTLEROY MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****97

License Status

NOT RENEWED

Business

First Name

JENNIFER MARY

Last Name

FAUNTLEROY

Suffix

Business Name

JENNIFER MARY FAUNTLEROY MD

Original Issue Date

01/01/1997

Expiration Date

07/31/1984

City

CARBONDALE

State

Zip

62901

County

JACKSON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006