JUCELLE HABACON OCCIDENTAL MD 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

JUCELLE

Middle

HABACON

Last Name

OCCIDENTAL

Business Name

JUCELLE HABACON OCCIDENTAL MD

Original Issue Date

12/04/2003

Effective Date

12/04/2003

Expiration Date

07/31/2005

City

SPRINGFIELD

State

Zip

62786

County

SANGAMON

Controlled Substance Schedule

II III

Ever Disciplined

LastModifiedDate

10/09/2006