JEREMY RALPH MONROE DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****98

License Status

NOT RENEWED

Business

Title

First Name

JEREMY

Middle

RALPH

Last Name

MONROE

Business Name

JEREMY RALPH MONROE DO

Original Issue Date

08/31/2011

Effective Date

05/19/2014

Expiration Date

07/31/2017

City

PEKIN

State

Zip

61554

County

TAZEWELL

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017